Insurance Fraud stories

[Anonymous]

Anonymous wrote:

Anonymous wrote:An employee...faked a workers comp claim.

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).

Interesting. I'm the 23:14 poster. My employee (in a county on the eastern shore of Maryland) uses a Baltimore City attorney for all
of her family's workers comp claims.

[Anonymous]

Anonymous wrote: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/

I'm the PP and this happens in baltimore city. There are certain attorneys who police/fire go to who refer to specific doctors/physical therapists. They exaggerate symptoms which prolong treatment. There's even a specific psychologist who all of them go to who knows exactly what to write. Like I said though the commission let's this happen, even when there's proof of these people living full lives and not needing treatment.

[Anonymous]

Anonymous wrote: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

Didn't some doctor in NoVA get busted for exactly this? It was Amazon returns though and ran into the hundreds of thousands.

[Anonymous]

Anonymous wrote:

Anonymous wrote: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

Didn't some doctor in NoVA get busted for exactly this? It was Amazon returns though and ran into the hundreds of thousands.

I remember that, didn't make any sense. It seemed like he was in one of the higher paying specialties as well from what I remember. SMH

[Anonymous]

Anonymous wrote: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/

I know a DC cop who I’m pretty sure is committing workers comp fraud. A different injury every year which keeps him out of work for months and usually requiring some sort of minor surgery. However, doesn’t ever seem hurt and able to live a full life of camping/snowboarding/being active/etc.

[Anonymous]

Anonymous wrote: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 (!).

This! This is the real fraud. Property, Health and pretty much all other insurance companies perpetrate fraud on us plebes, all the while enabled by our elected f*cktards and the people that are supposed to monitor them. If someone successfully screwed them over, hats off to them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:An employee...faked a workers comp claim.

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).

Been working in comp for >20 years. SO much fraud. It is unbelievable what I see every single day. System is stacked against insurers. We all pay for it. From malingering and ridiculous amounts of over treatment to out and out false claims.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:An employee...faked a workers comp claim.

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).

Interesting. I'm the 23:14 poster. My employee (in a county on the eastern shore of Maryland) uses a Baltimore City attorney for all
of her family's workers comp claims.

This is not uncommon. The workers comp bar is small and no one wants someone who doesn’t know the law representing them. If the lawyer is good and has experience in the area of workers comp, it is a wise decision to select that attorney. This isn’t even a red flag.

[Anonymous]

hail damage roof claims in areas like nova where there is no hail

[Anonymous]

Anonymous wrote:hail damage roof claims in areas like nova where there is no hail

So you think the insurance adjuster that works for the insurance companies is approving fictitious claims?

[Anonymous]

My neighbor burned down their house but managed to pull out the two Porsches and his multi 100k watch collection first. This was years ago.

[Anonymous]

Anonymous wrote:

Anonymous wrote: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.

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?

Nope, they park next to you and ask you for $200 claiming you caused some scratch on their car.

[Anonymous]

Anonymous wrote:

Anonymous wrote:An employee...faked a workers comp claim.

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).

Ha, came here to post about my former neighbor in Baltimore City who was very obviously committing worker’s comp fraud.

[Anonymous]

Anonymous wrote:

Anonymous wrote: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/

I know a DC cop who I’m pretty sure is committing workers comp fraud. A different injury every year which keeps him out of work for months and usually requiring some sort of minor surgery. However, doesn’t ever seem hurt and able to live a full life of camping/snowboarding/being active/etc.

This baltimore city officer, in addition to selling oxy and cocaine, also had close to 20 workers comp claims. I guess they won't bother looking into those any longer

https://www.wbaltv.com/article/baltimore-officer-s...-on-drug-distribution/40605374

[Anonymous]

Car insurance. It is common to call in and add rental car to your insurance policy.
Then wait 30 min to phone in a claim