A Breakdown of Auto Insurance Fraud

Insurance fraud can cost insurance companies a lot of money and trouble.  In 2012, there were about 143,000 requests made to the Crime Bureau for help in investigating suspicious claims.

About 10% of insurance fraud is perpetrated by organized fraud rings.  In contrast, 90% of insurance fraud is comprised of padding up claims as well as adding on damage, injuries, and non-existent passengers to a claim.

One third of all bodily injury claims have fraud involved.  In fact, fraud costs insurance companies about $30 billion a year.  That’s a big chunk of change!

And the perpetrators are not stupid.  They employ many different types of fraud techniques.

So what are some the different types and signs of insurance fraud?

A Few Types of Insurance Fraud

Perpetrators of insurance fraud can use all sorts of different techniques to try and defraud insurance companies.

A paper accident is a type of accident that only exists on paper.  A perpetrator may ask a person in auto repair or salvage to assist in creating an accident.  In addition, doctors, lawyers, and insurance agents may also get in on the scam.

The fraud known as hit and run occurs when a person tries to claim for existing damage.  They may call the police and tell him that the car was damaged by a hit and run driver.

Other people like to inflict deliberate damage on their property and ask the insurance company to pay for it, telling them it was the result of an accident.

In addition, there are some people that would go so far as to fake an accident.  And some fake damage to themselves in order to collect on personal injury claims, disability, or worker’s compensation.

Types of Auto Accident Fraud

One of the many types of insurance fraud out there is auto accident fraud.  Perpetrators of this type of fraud are not only defrauding insurance companies, but can also cause an innocent motorist’s insurance premium to rise.

The T-bone fraud technique occurs when a perpetrator waits for a victim at an intersection with no impartial witnesses.  Then when someone crosses the intersection, he rams them.  Once the police arrive, the perpetrator provides fake witnesses who claim the victim ran a red light or a stop sign.

In a sideswipe, the perpetrator frequents highways with multiple left hand turn lanes where he continuously makes left turns.  Once a driver in the lane next to him drifts into his lane, he speeds up and rams them.  Since the victim drifted into his lane, the victim is seen to be at fault.

The wave fraud can be seen as an act of betrayal.  In this type of insurance fraud, the perpetrator waits for a victim who is in a yield lane.  He waves to for that victim to merge in front of him and then when the victim does, speeds up and hits him.

A swoop and squat requires a perpetrator’s car accident ring to organize an accident with a victim.  They plan and maneuver so that the victim ends up rear ending one of the perpetrators.


Is a Claim Bogus?

Though fraud is a problem for the insurance industry, there are several signs that could point to a bogus claim.

One of the signs that a claim is fraudulent is if the claimant has a lot of debt and financial pressure.  This could lead him to try and fraudulently collect on a policy.

Another tip is if the claimant increased or added more insurance onto a policy shortly before an accident.  If a person is calm after losing something of value, it could also indicate that he is involved with some sort of fraud.

The use of suspicious hand written repair or replacement receipts or the lack of a police report is also a good sign of fraud.

With all the different kind of fraud scams out there, law abiding citizens have to be careful.  Insurance fraud not only affects the insurance companies, but can also affect innocent people as well.  So keep on your toes and keep your eyes open!

Mercury Insurance has been named one of "America's Most Trustworthy Companies" by Forbes magazine. Headquartered in Los Angeles, Mercury (NYSE: MCY) primarily provides car and homeowners insurance through a network of 6,700 independent agents in 13 states. 

"Mercury is in the midst of celebrating its 50th anniversary and this prestigious honor from Forbes validates our long-standing efforts to supply affordable insurance and unsurpassed service for our millions of customers," said Mercury CEO Gabe Tirador. "For the past five decades Mercury has operated with the belief that personal relationships are important to consumers, and these relationships – whether with the company or with our agents – help to create trust. This blueprint is obviously still true today." 

Forbes enlisted GMI Ratings to examine more than 8,000 companies traded on U.S. exchanges and to sort the 100 honorees into three groupings – large-cap, mid-cap and small-cap companies.  (Mercury is ranked among The Most Trustworthy Mid-Cap Companies; the fourth time the company has received this distinction.)  GMI assessed more than the raw data on companies' income statements and balance sheets, also examining the true quality of corporate accounting and management practices.  The goal, according to GMI's valuations, was to find "companies (that) have consistently demonstrated transparent and conservative accounting practices and solid corporate governance and management." 

"My entire career has been dedicated to the insurance industry, so I deeply appreciate this tribute from a publication that has been such a vital part of America's business culture," says George Joseph, Mercury 90-year-old chairman and founder, who still works five days a week at the company's office in the heart of Los Angeles.  “Mercury was founded to provide lower rates for a wide variety of consumers, and we're proud to say that 50 years later this philosophy remains the basis of our success." 

ABOUT Mercury Insurance (www.mercuryinsurance.com) 

Mercury Insurance (MCY) is a multiple-line insurance organization offering predominantly personal automobile and homeowners insurance through a network of independent agents in California, Florida, New Jersey, Texas, Arizona, New York, Georgia, Oklahoma, Illinois, Michigan, Nevada, Virginia and Pennsylvania. Since 1962, Mercury has specialized in offering quality insurance at affordable prices – core values that distinguish Mercury in the marketplace.

H2 is your full service insurance brokerage.  We will happily review you current policy to check for added benefit we can offer and to make sure you are not under uninsured in any area. 

Ozier Muhammad/The New York Times

FEW things in our financial lives could be as tedious yet as important as reviewing the policies that insure what we own. Hours spent poring over pages written in arcane language can seem totally wasted. So we don’t do it.
But avoiding the issue does not make it go away. Without going through your policies annually, how will you know if all your assets are actually covered?

“People do not keep their insurance policies up to date with their lifestyles,” said Charles Williamson, president of the private client group at Chartis Insurance, a subsidiary of the American International Group.

Beyond the yearly checkup, he recommends that people seek new bids for all of their nonlife policies every three to four years. “This business changes, and there are opportunities to get more coverage and service, and perhaps save some money,” he said.

Here is a look at what you need to do as part of any financial health review:

AUTO No night of television passes without a barrage of auto insurance ads, all promising to save you money. But while insurance companies try to woo you, their pitches do not always compare apples and apples.

“You can say I saved $100 on my auto insurance, but what did you give up in the exchange?” said Brad Cooper, senior vice president for marketing at InsWeb, an online brokerage. “Any insurance agent can save you money, but they’ll raise the deductible. Can you afford that $1,000 deductible?”

This is where reading the fine print is crucial. Otherwise you could find yourself in a car accident without the means to pay for the repairs.

The other area that needs review is coverage of young drivers. If they are on your policy, they will certainly cause your rates to spike. But discounts are available when your children go away to college and are not driving year-round, so you should check your policy then, said Lisa Lobo, vice president for personal lines at the Hartford Financial Services Group. Likewise, people who drive less because they are working from home could be eligible for discounts.

Uninsured motorist coverage is another thing to check on your policy. It is pretty expensive — a couple of hundred dollars a year for each $1 million in coverage — but that is because it is meant for your protection against someone without insurance who damages your car or injures you. James A. Fiske, national marketing manager for Chubb, noted that in California one in four drivers was uninsured, and in New York that number is one in seven.

HOME Given the drop in home prices in the last two years, many consumers seem to think they can save money by lowering the insured value of their house. If they paid $500,000 for the home and they could sell it now for only $350,000, why not reduce the coverage? That might seem logical, but the cost of rebuilding that house may not have fallen as sharply.

“Sticks and bricks and labor and construction have not dropped,” Mr. Fiske said. “It’s been fairly flat over the past few years.”

Of course, a total loss on a house is a rare occurrence. So it is usually more important to keep upgrades current on your policy. Putting an addition on the house is an obvious time to call your insurer — you have physically added to the size of your home. But if you upgraded your kitchen with granite countertops and high-end appliances, that has changed the value, too, and your insurance company will want to know.

“If the carrier is unaware of the upgrade, that won’t be in the policy,” Ms. Lobo said.

Even if you have not changed anything, newer homeowners’ policies contain innovations. Last year, dozens of Bernard L. Madoff’s victims received payments under a relatively new “fraud safeguard provision” in their Chartis policies. “Some claims were up to $100,000, which is not much with a $15 million loss, but it’s something,” Mr. Williamson said.

PERSONAL PROPERTY While homeowners’ policies cover some of the contents of the home, there are limits. The average homeowner probably thinks $50,000 for contents would be fine, but add in flat-screen televisions, some audio, video and camera equipment, and that limit is hit pretty quickly. Now imagine unique jewelry, expensive watches, a collection of wine or antiques — all those mean it is time to sign up for a valuable personal property policy.

Ms. Lobo said that if an item was worth more than $5,000 it should be added to a personal property policy. “You may not have something that meets that criteria, but there may be extra computers where you could get additional coverage through a basic endorsement,” she said. (An endorsement is any addendum to cover something specific.)

This is also an area of concern with renters’ insurance. A standard renters’ policy has a limit on the value of the contents in the apartment, but that coverage can be increased with a separate policy.

Yet listing valuable items is not a one-time process. First, that list will grow or shrink, and second, the values for these items will go up or down. “I know it’s unusual for the insurance guy to say this, but they may be insured for too much,” said Mr. Fiske. “Or if you haven’t updated this in many, many years you could be dramatically underinsured.”

LIABILITY Do you have insurance to cover you beyond the liability limits on home and auto policies? These so-called umbrella policies are meant to guard against catastrophic occurrences. The coverage is a couple of hundred dollars per million dollars of coverage, but many people are not sure if they need it.

Mr. Williamson said the major factors in determining how much liability coverage to have were lifestyle, net worth and public prominence. Another consideration is where you live. The five areas where lawsuits are most likely to go in the plaintiffs’ favor are South Florida, West Virginia, greater Chicago, New Jersey and New Mexico, according to the American Tort Reform Association.

For less prominent people, other contributing factors include having young, driving-age children and entertaining in the home. The reason is that parents are held responsible for their children if they injure someone, and a guest who drinks too much at your party and crashes his car into someone else could also be your responsibility.

Mr. Fiske said a liability claim for a run-of-the-mill car accident where someone was injured would be $300,000 to $500,000 but could quickly hit $1 million. He tells the story of a young driver who went out for fast food before his parents woke up. Another driver hit him, causing the young driver’s car to careen into a nurse, severely injuring her. Even though the crash was not the young driver’s fault, the nurse went after his parents to pay for her medical costs and lost wages.

The bottom line is you need an insurance checkup annually. Whether you are going directly to an agent or through a broker, your premium contributes to their pay. “The consumer should demand a review every year,” Mr. Fiske said. “You should set the expectation that you should be serviced for that.”