NICB Says Fraudulent Claims Spiked 27 Percent Since 2010
February 12, 2013

by Casey Neeley,

The National Insurance Crime Bureau (NICB), funded by insurers, has released its 2012 questionable claims (QC) referral reason analysis for all insurance claim referrals made in 2012, showing an increase of 26.7 percent in QCs from 2010 to 2012.

Auto glass fraud referrals saw the most dramatic decline over the past two years, down 63 percent from 2010 to 2011, in addition to decreasing another 12 percent from 2011 to 2012. Only 722 QCs were filed for auto glass-related fraud this past year compared to 2,182 potentially fraudulent filings in 2010.

QC reports of inflated damage and hail damage, however, saw increases of 19 percent from 2011 to 2012. Over the year, questionable property claims increased an average of 39 percent. Inflated billing (19 percent), duplicate billing (15 percent) and billing for services not rendered (4 percent) also grew from 2011 to 2012.

For vehicle claims most likely to receive a questionable referral, hail damage topped the list with a 35 percent jump from 2011 to 2012. Hail damage referrals were number one on the list the past year as well, with a 72 percent increase from 2010 to 2011. Referrals resulting from auto body and auto repair shop work also grew 22 percent over the year, while referrals resulting from inflated repair costs saw a 21 percent hike.

According to a release issued by the NICB, "Questionable claims are those claims that NICB member insurance companies refer to NICB for closer review and investigation based on one or more indicators of possible fraud. A single claim may contain up to seven referral reasons."

The 2012 number sets a new record; 2010 saw 91,797 QCs, 2011 was reported at 100,450 while 2012 saw a total of 116,268 QCs.

"The report examines six referral reason categories of claims: property, casualty, commercial, workers' compensation, vehicle and miscellaneous referred in 2012, with those referred in 2010 and 2011," reads the NICB statement.

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