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How are fraudulent insurance claims identified?

On Behalf of | Nov 14, 2019 | White Collar Crimes

While the majority of insurance claims filed are legitimate, insurance companies are constantly on the lookout for fraudulent claims. To help identify them, the National Insurance Crime Bureau created a list of suspicious loss indicators, which investigators look for to determine whether a claim may be fraudulent.

When massive damage occurs to your home, you will probably have an emotional reaction to the situation. After all, you have both a financial and sentimental attachment to your home, and even with insurance coverage in place you’re bound to experience stress regarding the matter. That’s why insurance adjusters find it so odd when a person reacts without emotion to the claim filing process. While not exactly evidence of wrongdoing, your demeanor could raise alarms for the investigator if it falls outside of what’s considered the norm.

Activities involving your insurance will also be scrutinized. For example, increasing coverage just before a claim is submitted is considered suspicious activity by most insurance companies. While it may be a coincidence, it could also be that the action was taken deliberately in an attempt to defraud the insurance provider. The circumstances surrounding the incident will also be taken into account, such as a fire breaking out in a home right after all of the inhabitants vacated the property.

When making an insurance claim you may be asked to submit receipts or invoices regarding the repair or replacement of damaged items included in your insurance coverage. To ensure their validity, agents want to see the original receipts, which prove that the amount you’re claiming is backed by evidence. Providing a handwritten or personally created receipt detailing these expenses will usually be frowned upon because the agent has no way to verify whether the repairs actually cost that much.