Kingpins and common folk.It's a crime for everyone. From the average policyholder Policyholder An individual who owns an insurance policy. to body shop owners, physicians, lawyers and now, members of organized rings--a host of criminals are attracted to insurance fraud, and their success is costing the insurance industry about $80 billion a year But insurers are not taking the assault lying down. "Insurers take fraud very seriously," said Jeanne Salvatore, vice president for consumer affairs for the Insurance Information Institute. For a while, they were reluctant to make their efforts to curb fraud known because they feared they would appear anti-consumer, but now there is a growing awareness among consumers that fraud hurts them, too, she said. Salvatore works with insurers' special investigation units to get media coverage for their fraud-fighting activities. One indication of insurers' serious regard for fraud is that "they hire people who have extraordinary law enforcement expertise" to serve in their SIUs, Salvatore said. Many investigators are working in the same jurisdictions they served as police officers, so they know the territory, she said. And it is a complex territory. In addition to exaggerated-value theft claims, staged auto accidents, weekend-injury workers' compensation workers' compensation, payment by employers for some part of the cost of injuries, or in some cases of occupational diseases, received by employees in the course of their work. claims and other traditional seams, technology and the Internet are offering new opportunities for fraud, as well as new tools for combating it. To explore the many facets of insurance fraud, Best's Review prepared a "Big Picture" report, one of our packages that examines a topic from as many angles as possible, providing more information, more ways of looking at things and more views from more people. Our findings appear in "Dealing in Fraud," beginning on page 24. Although it's difficult to say whether insurance fraud is increasing overall, there are increases in some areas. Fraud involving no-fault insurance no-fault insurance, type of indemnity plan, usually applied to automobile coverage, in which those injured in an accident receive direct payment from the company with which they themselves are insured. in New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of , for example, has exploded ex·plode v. ex·plod·ed, ex·plod·ing, ex·plodes v.intr. 1. To release mechanical, chemical, or nuclear energy by the sudden production of gases in a confined space: in recent years, Salvatore said. Yet, the good guys' efforts are paying off. According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. the Institute, arrests for insurance fraud in New York during 2002 rose 27% from the previous year and more than 400% since 1996. And the battle rages on. Sally Whitney is editor. You may reach her at (908) 439-2200, Ext. 5340, by writing to A.M. Best Co., Ambest Road, Oldwick, NJ 08858, or by e-mail at sally.whitney@ambest.com.The e-mail address See Internet address. e-mail address - electronic mail address for Best's Review is bestreview@ambest.com. |
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