Fraud and Buildup in Auto Injury Insurance Claims PDF Download

Author: Insurance Research Council
Publisher:
ISBN: 9781565940338
Category :
Languages : en
Pages : 210

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Author:
Publisher:
ISBN: 9781565940406
Category : Automobile insurance
Languages : en
Pages : 101

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Author: Insurance Research Council
Publisher:
ISBN: 9781565940079
Category : Automobile insurance
Languages : en
Pages : 110

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Author: Insurance Research Council
Publisher:
ISBN: 9781565940376
Category : Automobile insurance
Languages : en
Pages : 49

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Author: Insurance Research Council
Publisher:
ISBN: 9781565940758
Category :
Languages : en
Pages : 15

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Author: Joseph Lichtor
Publisher: Lawyers & Judges Publishing
ISBN: 1930056346
Category : Social Science
Languages : en
Pages : 190

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Book Description
Using numerous examples, an orthopedic surgeon spotlights the growth industry of health care scams since the 19th century's "railway spine" epidemic. After overviewing the history of personal injury fraud in the US and Europe, Dr. Lichtor clearly explains the expected mechanics of specific injuries; patient evaluation, including investigation of the patient's accident history; and prevention of claimant and physician deception relating to such alleged injuries as whiplash, back injury, traumatic fibromyalgia, repetitive motion injury, and aggravation of pre-existing conditions. He concludes with chapters on malingering, Worker's Compensation Fund fraud, and federal fraud enforcement. Annotation copyrighted by Book News, Inc., Portland, OR.

Author: Dan Baldyga
Publisher: AuthorHouse
ISBN: 1588205746
Category : Law
Languages : en
Pages : 141

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Book Description
Auto Accident Personal Injury Insurance Claim reveals the inside secrets of claim negotiating and shows you how to settle your case for top dollar. This book will guide you through the insurance claim wilderness and provide you with the answer to that critical question: How much is my "pain and suffering" worth? The mystery of how to place a value on your "pain and suffering" has been solved with the introduction of BASE: The Baldyga Auto Accident Settlement Evaluation Formula. It will help you to prove your losses, and to know how to present them during your negotiations. Youll learn the all-important 4 "Values" that BASE provides for you: The PREMIUM Value, The MEAN Value, The CORE Value and The LOW Value. The BASE Formula is a simple, yet revolutionary evaluation tool. Knowing how to guide an accident claim to a victorious payoff is not an exclusive ability, possessed by a select few. Dont be seduced into thinking you cant do it yourself. That simply isnt true! This book will show you how. If youve been in an accident and youre uninformed, you have little or no concept of the ultimate value of your possible recovery. Because of this, youre less able to make appropriate demands. As the claims negotiation process moves towards a close, youre settlement demands are very often too low or too high. Youre ignorant of the accepted principles, which justify your demands. When you attempt to negotiate a settlement with these handicaps, you run a strong chance of being victimized. The amount of compensation you should be paid isnt found in a crystal ball. Rather, a number of simple factors such as the type of accident, related injuries, out-of-pocket expenses, medical costs and lost wages all go into determining how much a claim is worth. What amount an insurance company is willing to pay actually falls into a fairly narrow spectrum. To read this book is to become informed on bodily injury claim settlement facts and details. Youll discover how to implement BASE so you can determine the monetary value of the "pain and suffering" youve endured because of your injury. Youll know what to ask for and how to negotiate it. Youll learn how to supply the adjuster with all the documentation and proof needed to establish your claim. Youll gain the knowledge needed to accomplish this when you read Auto Accident Personal Injury Insurance Claim. And youll walk away from the negotiation table with a smile on your face.

Author: Barry Zalma
Publisher:
ISBN: 9781704294742
Category :
Languages : en
Pages : 460

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Book Description
Insurance Fraud Is Epidemic Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number. Most attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year.Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected. Those that are detected do so because they became greedy, sloppy and unprofessional so that the attempted fraud becomes so obvious it cannot be ignored.The National Insurance Crime Bureau (NICB) estimates that almost 25% of the bodily injury claims related to auto crashes are bogus. Property and casualty claims against auto insurance are not much better, coming in at around a 10% fraud rate.A person commits the offense of insurance fraud by knowingly and with the intent to defraud any insurer presents or causes to be presented to any insurer any statement forming a part of, or in support of, a claim that contains any false, incomplete or misleading information concerning any fact or thing material to the claim. [18 Pa.C.S.A. § 4117(a)(2).] A person acts "knowingly" when he or she is aware that it is practically certain that his or her conduct will cause such a result. Likewise, a person acts "intentionally" when "it is his or her conscious object to engage in conduct of that nature or to cause such a result.As the industry attempts to keep pace with fraudsters' varied, ever-shifting tactics, it must deploy more innovative, effective anti-fraud technologies or risk dire losses. Vendors and organizations include the Coalition Against Insurance Fraud (CAIF), CSC, Detica NetReveal, Equifax, Experian, FICO, IBM, Innovation Group, Insurance Bureau of Canada (IBC), ISO/Verisk, KPMG, LexisNexis, Mattersight, Mitchell, the National Insurance Crime Bureau (NICB), SAP, SAS, and TransUnion.Insurers must also generate a close relationship with the state insurance department's fraud division or fraud bureau, local police agencies, the FBI, the ATF, the Postal Investigation Service, the local fire department's arson unit, local prosecutors, and the local U.S. Attorneys if they are to have any chance to reduce the effect of insurance fraud. Insurers should also work to make the general public, state legislators, state governors, congress members and U.S. Senators, and the Attorney General of the United States aware of the effect insurance fraud has on the public at large and the insurance industry.Wherever insurance is written insurance fraud exists. It is an equal opportunity fraud committed by people of every race, religion or national origin. Insurers who do not exercise serious anti-fraud efforts often complain that the local district attorneys and police agencies give a low priority to the crime of insurance fraud. No matter how seriously the insurers work to prove fraud the authorities often ignore them. In response, police and prosecutors complain that the insurers do nothing that police and prosecutors can use to prosecute the crime of insurance fraud while insurers complain that prosecutors ignore them when they present evidence of a fraud. There is truth in both complaints. Insurers, although compelled by statute to investigate potential insurance fraud and to present the results of their investigations to prosecutors, they are not trained as police officers. This book is written to make it clear to insurers, police and prosecutors that it is necessary to stop complaining and start working together to reduce the extent of insurance fraud. If they do not work together the crime will continue to metastasize until it will be impossible to write insurance at a profit or for a price anyone can afford.

Author: United States. Department of Transportation. Automobile Insurance and Compensation Study
Publisher:
ISBN:
Category : Automobile insurance
Languages : en
Pages : 260

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Author: Barry Zalma
Publisher: Independently Published
ISBN:
Category :
Languages : en
Pages : 408

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Book Description
INSURANCE FRAUD IS EPIDEMIC Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number. No one knows the amount that is taken by insurance fraud because most attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year. The only certainty is that it is a serious crime that bleeds the insurance industry sufficiently to have states compel insurers to create special investigative units (SIU's) to investigate, deter and defeat insurance fraud to assist the state in its efforts to prosecute the crime. Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected. Those that are detected do so because they became greedy, sloppy and unprofessional so that the attempted fraud becomes so obvious it cannot be ignored. The National Insurance Crime Bureau (NICB) estimated that almost 25% of the bodily injury claims related to auto crashes are bogus. Property and casualty claims against auto insurance are not much better, coming in at around a 10% fraud rate. The National Association of Insurance Commissioners (NAIC) reports that insurance fraud occurs when an insurance company, agent, adjuster or consumer commits a deliberate deception in order to obtain an illegitimate gain. It can occur during the process of buying, using, selling, or underwriting insurance. Insurance fraud may fall into different categories from individuals committing fraud against consumers to individuals committing fraud against insurance companies. Non-medical insurance fraud is estimated at over at $40 billion dollars per year. Fraud not only inflicts extra costs on insurance companies, but it also financially impacts consumers, costing the average U.S. family between $400 and $700 per year in premiums. When insurers and governments put on a serious effort to reduce the amount of insurance fraud the number of claims presented to insurers and the pseudo-government-based or funded insurers drops logarithmically. Insurance fraud is not limited to the US. In Britain fraud costs the British economy amounts estimated in billions of British pounds. Since the amount of fraud actually detected is a small portion of what was actually found, the estimates published are little more than an educated guess. Vendors and organizations include the Coalition Against Insurance Fraud (CAIF), CSC, Detica NetReveal, Equifax, Experian, FICO, IBM, Innovation Group, Insurance Bureau of Canada (IBC), ISO/Verisk, KPMG, LexisNexis, FastCase, Mattersight, Mitchell, the National Insurance Crime Bureau (NICB), SAP, SAS, and TransUnion. No matter how seriously the insurers work to prove fraud the authorities often ignore them. In response, police and prosecutors complain that the insurers do nothing that police and prosecutors can use to prosecute the crime of insurance fraud while insurers complain that prosecutors ignore them when they present evidence of a fraud. There is truth in both complaints. Insurers, although compelled by statute to investigate potential insurance fraud and to present the results of their investigations to prosecutors, they are not trained as police officers. Insurance company employees, whether claims adjusters or SIU investigators are not trained to present evidence of a crime to a court. They can only advise professional insurance fraud investigators at the state departments of insurance or state police agencies who must then investigate further to obtain evidence that is sufficient for a charge of insurance fraud or to convince a Grand Jury to issue an indictment.