Insurance Fraud: A Positive Change in Attitude

Attitudes toward insurance fraud are changing. According to a study by the Insurance Research Council  (IRC), 24 percent of respondents believe that padding a claim is acceptable as a way to compensate for the deductibles policyholders have to pay. While still high, that figure represents a significant decline from 33 percent in 2002. Eighteen percent of respondents to the 2013 survey indicated that padding a claim to make up for past premium paid — in years without losses — is also acceptable. The IRC notes that this is the lowest level since it first started tracking the issue in 1981.

Further, consumer support for antifraud measures is on the rise. IRC found that:

  • 80 percent of respondents are willing to participate in claim-handling processes that help reduce insurance fraud (for example, examinations under oath and independent medical examinations)
  • 82 percent agree fraudsters should be prosecuted to the fullest extent of the law
  • 66 percent support legislation that would limit attorney and medical provider access to police reports for soliciting new clients (up significantly from 2002, IRC observes)

The positive revelations are a reflection of the industry’s efforts at educating consumers. But more work remains. In addition to implementing antifraud measures, claims departments are demonstrating that such steps will not impede superior customer service for meritorious claims. With claim-scoring tools such as ClaimDirectorSM, claims professionals can identify meritorious claims for faster handling while flagging those that require additional investigation.

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Thomas Mulvey

Thomas Mulvey has been in the business of insurance investigations for more than 27 years. In his current position, he serves ISO as assistant vice president of SIU and claim services. He is also the coordinator of ISO’s Insurance Fraud Management Conference.