May 25, 2012

Where Questionable Insurance Claims Come From

Wanna blame someone for your high insurance premiums? Point to the residents of California, Florida, Texas, New York and Michigan.

Combined, these five states generate half of the nation’s questionable insurance claims — most of which are either suspect auto policy submissions or fake injury claims.

These states account for 49 percent of all “questionable claims” as tabulated by the National Insurance Crime Bureau (NICB).

Questionable claims are those claims that NICB member insurance companies refer to NICB for closer review and investigation based upon one or more indicators of possible fraud. NICB just released its three-year analysis of questionable claims in the United States from January 1, 2008 through December 31, 2010.

New York, Los Angeles, Houston, Tampa and Detroit are the cities generating the most QCs. Florida has three cities in the top 10 for QCs—Tampa, Miami and Orlando.

Of course, a large reason that these states have so many fishy claims is that they are so large. Some 110 million people live in the five states mentioned.

But while they do contain about 36% of the nation’s population, that doesn’t actually explain why these locations create 49% of the questionable claims.

Risk Management Magazine and Risk Management Monitor. Copyright 2012 Risk and Insurance Management Society, Inc. All rights reserved.

About the Author

Senior Editor

Jared Wade is the senior editor of Risk Management magazine and the Risk Management Monitor blog.

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