Many of us may not be surprised about the relationship between the desperate state of the economy and influx in fraudulent insurance claims. Throughout the country there has been a sense of fear and uncertainty about the future of personal finance and job security. This threat has been causing many to react indifferent and often resort to criminal activities to provide themselves with a false sense of financial stability. With the insurance industry compiling thousands of different companies and having trillions of dollars infiltrating in premium payments, it makes the industry a prime candidate for crime. (www.fbi.gov)
In 2008, there was a Pennsylvania couple charged with fraud after they submitted claims for more than 11 accidents. They reported claims for damage and medical bills for allegedly crashing into various stationary items such as parked cars, trees and utility poles. In addition, they submitted claims for medical appointments that they were not present for and both received several prescriptions for pain medications. (www.post-gazette.com)
The issue of insurance fraud in this country should be of concern for everyone. Statistics say that one in five US adults believe that it is acceptable to defraud insurance companies. (Four Faces of Insurance Fraud, Coalition Against Insurance Fraud, 2008). It is estimated that insurance fraud, not including health insurance, is approximately costing the American public over $40 billion a year. This can translate into increased premium rates between $400 and $700 for the average household. (www.about.com) We all have a civic duty to be aware and fight against this problem.
It is estimated that three percent of slip and fall injuries are fraudulent. (National Floor Safety Institute) False injury claims in conjunction with litigation costs can reach approximately $2 billion dollars a year. (www.insurancefraud.org)
In 2003, a New Jersey man was charged with fraud in a slip in and fall scam. The injuries had supposedly been sustained during a 1999 bus trip on an Elizabeth bus route. He submitted over $6, 000 in false claims. He was ordered to pay restitution to Sedgwick Claims Service and Aetna/ US Healthcare and was placed on three years probation. (www.njinsurancefraud.org) In 1999, another case was that of Ernest Woodson, a Vineland man, who used 7 aliases, making 21 phony claims in a period of a little over 1 year. He attempted to obtain close to $32,000 in insurance claims from 19 different establishments. He pled guilty to theft and fraud charges. He was ordered to pay restitution for the $9,000 that he ended up finally collecting and faces up to a 1 year in prison. (www.njgov/lps, New Jersey Department of Law and Public Safety)
There are many cases ongoing throughout the country involving organized fraud rings and repeat offenders. According to a case in Pennsylvania, there were six involved in a long running slip and fall scam targeting several restaurants, grocery stores, convenience stores, bars and laundry mats. They would all “witness” the accidents of one another and use fake names and addresses to have the insurance checks mailed to. They are all facing various charges. (www.insurancejournal.com) There was another slip and fall fraud ring developed in Florida. Michael Evans of Hollywood had used several aliases while submitting claims for fake slip and fall occurrences all over the country. There were four other members of his family involved in this crime ring. He has been charged with many different charges including theft, racketeering and organized fraud. (www.claimsjournal.com)
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