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Between the Lines: March 2013

Maria Abate, attorney with Colodny, Fass, Talenfeld, Karlinsky, Abate & Webb, is one of four who answers, "What is the most unusual fraud story you’ve experienced?"

March 22, 2013 Photo

What is the most unusual or unique fraud story you’ve experienced?

“In my first civil lawsuit, I defended a surgeon accused of a botched carpal tunnel surgery. Plaintiff demonstrated how she had to contort herself just to use a cigarette lighter. We caught her on video repeatedly ‘flicking her BIC.’”

-David D. Ernst, Esq., Backus, Bland, Navarro & Weber. CLM and Insurance Fraud Committee Member since 2012.


“Our investigators have worked thousands of cases over the years, but one of the most unusual involved a workers’ compensation surveillance in which the claimant drove to an out-of-town bank, walked in, and committed armed robbery—all on tape.”

-David Merrill, President, ICS Merrill. CLM Fellow since 2008.


“Not satisfied with an ACV insurance payment for the purported robbery of his dune buggy engine, an insured sued on behalf of an entire class claiming entitlement to replacement costs. The rub? An investigation found that the original engine was never stolen.”

-Maria Abate, Esq., Colodny, Fass, Talenfeld, Karlinsky, Abate & Webb, CLM and Insurance Fraud Committee Member since 2009.


“A man witnessed a major accident involving a large van with a load of people onboard. In an attempt to ‘cash in,’ he ran and jumped into the van. He later claimed that he suffered injuries in the accident but was ratted out by the others.”

-Frank S. Goldstein, Esq., Goldstein Law Group, CLM and Insurance Fraud Committee Member since 2012.

 

$40 Billion

Estimated yearly cost of insurance fraud (non-health).
Source: FBI

27%

Percent increase in questionable claims from 2010 to 2012.

Source: NICB

68%

Percent who believe fraud occurs because people think they can get away with it.

Source: Accenture

$700

Potential annual increase in premiums per family due to insurance fraud.

Source: FBI

88%

Percent of insurers using anti-fraud technology

Source: Coalition Against Insurance Fraud

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About The Authors
Bevrlee J. Lips

Bevrlee J. Lips was managing editor of Claims Management magazine (now CLM Magazine) from January 2012 until March 2017.  blips@claimsadvisor.com

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CLM’s Insurance Fraud Committee identifies, analyzes, and offers education on emerging fraud schemes and tactics; monitors and reports on developments in case law, state fraud statutes and applicable regulations; collaborates with other anti-fraud industry organizations and associations; and seeks to provide amicus support in matters of importance in the fight against insurance fraud.

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