A claimant attorney reported the loss, stating the claimant was driving the insured vehicle when it was involved in a hit-and-run, head-on collision. Injuries to head, back, neck and arm were reported. Our investigation discovered not only the identity of the hit-and-run vehicle, but also that the driver was not listed as an insured driver… Read More
Uncategorized
Auto Fraud: Running through the medical mill
The insured reported that she was driving her insured vehicle when another vehicle ran a stop sign and collided with her. She complained of neck, back and side injuries; her two children and another passenger were also injured. The investigation revealed several red flags and discrepancies: soft tissue injuries, medical mill provider involvement and evidence… Read More
Auto Fraud: PIP claim fraud for dummies – how not to do it
The insured took out a policy for his Jeep; three weeks later he removed the Jeep from the policy and added an older Honda. A month later, he reported that while driving the (now-uninsured) Jeep he was involved in a multi-car rear-end collision, with neck and back pain. Other passengers were injured, he said. Red… Read More
Auto Fraud: Nothing’s as it seems
The accident was reported by a friend, stating that the insured vehicle was driven by the insured’s brother when he rear-ended another farm tractor and trailer. The insured was in the vehicle and complained of a dislocated/fractured hip. Two more passengers were in the vehicle, one of whom was also injured. Our investigation revealed several… Read More
Auto Fraud: Damage to a non-covered car
Vandalism, including a keyed door and dented hood, was reported by the insured’s lien holder. However, the claim actually occurred just three days after the vehicle was removed from the auto policy. Also, the damaged vehicle was an older model, yet had full coverage (with no inception photos). Murkier still was the fact that no… Read More
Medical Provider Fraud: A little too interconnected
Working with a claims management client, ISI obtained evidence of a chiropractor who was part-owner in several medical clinics and a law firm. Further investigation found that a group of injured workers were all represented by the same law firm and consistently received the same treatment/referral patterns. The chiropractor had been indicted; however, the various… Read More