California Ranks Highest for "Questionable" Claims by State for Last Three Years
July 1, 2011

The state of California has been ranked highest for the state with the most “questionable” claims in the latest report from the National Insurance Crime Bureau (NICB). The state-by-state ranking includes numbers from the last three years and analyzes what the NICB calls questionable claims—defined as “claims that NICB member insurance companies refer to NICB for closer review and investigation based upon one or more indicators of possible fraud."

NICB reports that it saw approximately 17,082 questionable claims reported in 2010 in California, 16,274 in 2009, and 15,609 in 2008.

Florida fell second on the list—but saw approximately 50 percent fewer questionable claims for the time periods in question. NICB reports that it received 8,724 reports of questionable claims in 2010 from Florida, 7,447 in 2009, and 6,506 in 2008.

The group, which is supported by more than 1,100 property and casualty insurance companies and self-insured organizations, also includes rankings by city—and reports that New York City toped the country for questionable claims, with 3,907 reported in 2010, 4,232 in 2009, and 3,613 in 2008. Three Florida cities made the national by-city rankings—Tampa, Miami and Orlando, which ranked fourth, sixth and eighth, respectively. Florida was the only state in which multiple cities made the top-ten list.

The report, which includes questionable claims over a variety of policy types, says personal auto policy claims (under which auto glass claims fall) topped the other insurance categories for questionable claims. Other categories include workers’ compensation, homeowners’ and commercial claims.

While auto glass claims have ranked high in some past NICB reports for “questionable claims,” the latest 2010 report includes the top ten questionable claims by referral reasons—and auto glass claims don’t show up on the list. Faked/exaggerated injuries rank highest, followed by vehicle theft, fictitious loses, lack of cooperation from insureds and prior loss/damage.

NICB’s last report, for the first-quarter of 2011, actually showed a 72 percent drop in “questionable” auto glass compared with the same period of last year.

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