Posts Tagged ‘insurance fraud’

Louisiana Insurance Department Targets Health Insurance Scammers

August 12th, 2010 by Iris | Comments Off | Filed in health insurance, insurance fraud, insurance news

Stories about insurance fraud abound in the auto insurance industry, but investigators in the Louisiana Department of Insurance Fraud Section have now served the American Trade Association, along with its thirteen companion companies and fourteen employees with “cease and desist” orders for selling fraudulently marketed “medical discount plans” as health insurance plans in the state of Louisiana.

The named companies, entities and individuals were ordered to cease and desist from all unauthorized insurance business, including delivering, issuing, mailing, offering, or soliciting any resident of Louisiana any kind of certificate, coverage, plan, policy, or “any other contract” which claims to provide insurance benefits or medical discounts for health benefits.

In addition to receiving C&D orders, the named people and companies were directed to provide a complete list of all Louisiana businesses or residents that had purchased any products from them, and report all premiums that were received in connection with those customers. In addition, they were required to notify any of the affected Louisiana consumers of the C&D order, and issue immediate refunds of any monies or premiums held in behalf of those consumers.

Along with the Louisiana Department of Insurance, the same scammers have had lawsuits and/or regulatory actions filed against them by the Federal Trade Commission and law enforcement agencies in 23 other states.

The FTC alone has filed three different lawsuits targeting fraudulent medical discount plans, and Attorneys General and Insurance Commissioners around the country have brought numerous actions to stop the scammers. Included among these lawsuits and actions are those addressing sham insurance, as well as illegal automated phone calls, fax blasting, and licensing violations.

Tags: , ,

Questionable Insurance Claims on the Rise

August 2nd, 2010 by Iris | Comments Off | Filed in auto insurance, homeowners insurance, insurance fraud

The Insurance Journal is reporting today that suspicious property and casualty insurance claims rose again in the first half of 2010, as compared to the first half of 2009.

The Journal cited a recent QU (questionable claims) report released by the National Insurance Crime Bureau, which examined six categories of referral reasons for claims: property, casualty, commercial, workers’ compensation, vehicle, and miscellaneous. Overall QCs increased by 14% in four of those categories in 2010, as opposed to 2009. These are claims which are referred to the bureau by member insurance companies that feel closer examination and examination is necessary because of indicators of possible fraud. A single claim can contain up to seven referral reasons.

This year saw a 107% increase in questionable hail damage claims and a 527% increase in questionable auto glass claims. Specifically, the bureau’s report notes: “Hail loss claims and QCs are generally concentrated in the central section of the U.S. However, seven of the top 10 states with the highest hail loss QC-to-claim ratio are not in the central section. This suggests that fraudulent hail losses can occur in any part of the country.”

Joe Wehrle, NICB’s president and CEO adds, “While there have been modest declines within a few categories of referrals, the 14 percent increase in the overall number of questionable claims for 2010 raises concerns.”

According to Wehrle, NICB, along with member insurers and law enforcement agencies have pursued unscrupulous roofing companies that take advantage of storms to fake or deliberately cause damage to roofs in an effort to get insurers to pay for a replacement roof that wasn’t damaged by a storm. Also under pressure from law enforcement, insurance companies and the NICB are staged accident rings, which are found in various regions including Tampa, FL, where this has become a major problem.

“We’re seeing concern from our members about criminal rings that are deliberately damaging vehicle windshields in order to file an insurance claim, and in some cases are not doing satisfactory repairs or replacements,” Wehrle said.

NICB is supported by nearly 1,100 property and casualty insurance companies and self-insured organizations.

Tags: , ,

Firing a Claim?

July 14th, 2010 by Iris | Comments Off | Filed in auto insurance, insurance fraud

A man in Belfast, Maine, is facing charges that he set a car on fire, and then posted photos of the flaming vehicle on Facebook.

The suspect, 36-year-old Asgard Tarick Gilbert, was arrested for felony arson roughly two weeks after local police found a1982 Mercedez-Benz smoldering on River Avenue.

According to the police, Gilbert told officers that he saw the car with a “small campfire” blazing in the back seat. They arrested him after examining his cell phone and computer, and watching surveillance tapes from a local store.

The owner of the car, which wasn’t working, had been trying to sell it.

Photo Credit: Belfast, ME Facebook Page | Click to enlarge

Tags: ,

Preacher’s Son Pleads Guilty to Church Arson

June 16th, 2010 by Iris | Comments Off | Filed in insurance fraud, insurance news

Maurice Arnold and Bruce Edward Smith – two thirds of a trio of men who were charged with arson in 2005, in connection with a fire that destroyed a church – pleaded guilty in Barrow County (Georgia) Superior Court. Two of three men charged with arson in a 2005 fire that destroyed a church pleaded guilty in Barrow County Superior Court in Georgia.

According to the prosecutors, the Reverend Quincy Arnold of Lawrenceville, GA, asked Maurice (his then-25-year-old son) to burn down his New Life Deliverance Church five years ago. They also say that Maurice Arnold hired Smith (age 48) to help him with his task.

The senior Arnold is expected to face charges in October, which will included insurance fraud, vandalizing a place of worship, first-degree arson, and conspiracy to commit a crime.

Superior Court Judge Currie Mingledorff has agreed to sentence Smith with two years in prison followed by fifteen years of probation, though the prison sentence is suspended on his arson plea.

The younger Arnold pleaded guilty to three charges: vandalizing a place of worship, conspiracy to commit a crime, and arson, and will be sentenced next month.

Tags: ,

Temp Agency Exec Charged with Insurance Flood

May 19th, 2010 by Iris | Comments Off | Filed in insurance specialists

One of the top executives of a temporary employment agency has been accused of scamming the New York State insurance Fund out of $25 million in workers’ compensation insurance premiums.

On Monday, Eric Goldstein pleaded not guilty to charges which included insurance fraud.

Prosecutors in Manhattan say Goldstein’s company, GT Systems, ran fifty temporary employment agencies. They also said that Goldstein had skipped out on the insurance premiums due to the state fund for years, while having employees make fake insurance certificates.

Goldstein, age 61, is also accused of under-reporting his payroll and mis-classifying his employees’ occupations, in order to reduce the workers’ compensation insurance rates he was charged.

Gerald Shargel, attorney for the defense, says that his client plans to fight the charges.

When representatives of the press attempted to contact GT Systems or its successor companies, calls were not returned.

Tags: ,

Insurance Fraud Not Limited to Auto Insurance

February 4th, 2010 by admin | Comments Off | Filed in insurance facts, travel insurance

Stories about auto insurance fraud and how to handle it if you’re a victim abound, as does advice on everything from how to spot the most common staged accident scenarios to how to deal with your insurance company if you’re run off the road, but insurance fraud is on the rise throughout the industry, not just within the realm of auto insurance.

Just as Internet scammers claiming to be collecting money for victims of the earthquake in Haiti, were trawling the internet for unsuspecting donators, there are as many types of fraud as there are insurance.

Recently, A. M. Best ran a story warning consumers about a rash of travel insurance fraud in Florida. In this case, the scam involved an unlicensed “insurance company” selling policies to cruise customers. All of the cruises were eventually cancelled, and over 300 complaints were logged before the company was shut down.

While that event was unfortunate, the more common form of travel insurance is on the consumer’s side, and involves travelers claiming missing bags that never existed, or claiming much higher values for the contents of their lost luggage, than their belongings are actually worth.

Whatever the form, insurance fraud is not likely to disappear. How can you protect yourself?

  1. Always purchase insurance from a reputable firm; if you’re not sure of a company’s track record, read reviews, and check with the BBB.
  2. Whether it’s auto insurance, homeowners insurance, or travel insurance, be sure to read all the fine print of your policy, and ask questions if there’s anything you don’t understand.
  3. Document everything, and take pictures whenever possible. Pictures of your belongings will help you track them later; pictures of accident scenes or damaged goods will help your claim get processed faster.
  4. Always cooperate with insurance investigators.
  5. Know your rights. Check with your state’s department of insurance for important consumer guidelines.

While it’s never a good thing to be a victim of insurance fraud, experiencing travel-related fraud is always a bit more jarring, especially since it often happens when you’re nowhere near the comfort of home. Remember that there are always people willing to help if you need it. Remember also, that your state’s insurance department keeps a list of all the licensed insurers in your state.

Tags: ,