Insurance Fraud stories
![[Post New]](/jforum/templates/default/images/icon_minipost_new.gif){kind=icon}
Anonymous
| Anyone have examples of real-life insurance fraud they have heard of? I have never, especially not big $, and am curious how commonplace it is. |
Anonymous
|
What kind of insurance - life, health, disability, property?
Certain types are much lower these days due to everything being computerized and easily searchable, plus there is software that analyzes and spots anomalies. I am not very familiar with property/casualty insurance, but I assume similar concepts as those used to identify fraud in health or DI would apply there. |
Anonymous
| Sounds like OP is looking for ideas to prove upon |
Anonymous
| ^ improve* |
Anonymous
|
Neighbor admitted to two incidents. One time they allowed hot water heater to continue to flood. Let it cause extensive damage to first level floors and laundry & kitchen lower cabinets.
After a huge storm knocked down lots of trees, he used pickup truck to pull leaning tree onto deck & storage shed. Claimed tree fell during storm Took out deck, hot tub, grill, riding lower mower, generator. . . Jerks. |
Anonymous
|
Yes, the previous owners of our beach house. I got flagged for all of the claims they put in. Here it is:
6K stolen jewelry 15 K roof damage 15 K siding wind damage 10 K siding wind damage 10 K water damage They did 0 upgrades to the home. They caulked the roof. The siding is still 30 years old. But, jokes on them. They will never have cheap insurance ever again. That said my friend in insurance was flabbergasted. Nearly 60K in 5 years. He believes someone had to help them with the fraud to get ot that level undetected. |
Anonymous
| An employee...faked a workers comp claim. |
Anonymous
I used to work in workers compensation for baltimore city. There's so much fraud there it's incredible. The system supports it though (plaintiffs attorneys, the commission, the general dysfunction of the city government). |
Anonymous
| I know several people that lied on property damage claims. Instead of saying walmart toaster they say the most expensive brand toaster, same with clothes and other possessions. It's not massive but still adds up to tens of thousands of dollars |
Anonymous
| It seems like everytime I park at a grocery store in Arlington someone tries to claim I hit their car. It's obvious I didn't but the police just shrug and say it's a common, low value sceme that isn't worth their time. |
Anonymous
How does that even work? Do they hit your car and claim you did it? Does your car have existing damage on it and they say you hit their car? |
Anonymous
|
This is anecdotal, but I’m a claims analyst (thrilling, I know) and have worked in the commercial/corporate insurance space for a year.
In my observation, I have seen no discernible “fraud” attempts. I will also say that insurance companies will do everything they can to deny a claim - you cannot over document. I’m much more concerned about insurance companies acting unethically, which they do - it is baked into the system. They are the “scum of the earth” according to my boss (!). |
Anonymous
| Elderly mom kept getting medical equipment delivered that she did not need. Knee braces specifically. Like several per week. Then the Medicare EOB would come showing that M was billed hundreds of dollars. I called M and reported this and returned the supplies with a letter telling them we were on to their scam and had alerted M. Never got another random thing. |
Anonymous
|
Workers comp and seems to be the biggest and most common one. Hundreds of NYPD officers had a ring of corrupt doctors who were submitting fraudulent injuries so the cops could milk workers comp and then retire early with injury bonuses. 106 officers busted for faking PTSD:
https://www.nytimes.com/2014/01/08/nyregion/retired-new-york-officers-and-firefighters-charged-in-social-security-scheme.html Separately, an NYPD cop was running an insurance fraud ring that would use doctors to overcharge insurance companies on behalf of car accident victims. They milked $100m from insurance companies. https://nypost.com/2022/01/13/doctors-law-workers-nypd-officer-bilked-100m-fraud-feds/ |