How do adjusters identify insurance fraud?

On Behalf of | Jun 23, 2019 | Firm News, Fraud

Insurance fraud is a big deal. Because this type of white-collar crime happens so often, insurance companies take very specific steps to identify fraud in all its forms to ensure the person responsible is caught and brought to justice. explains some of the ways insurance adjusters look for fraud. 

The National Insurance Crime Bureau has compiled a list of red flags to help adjusters recognize a fraudulent claim. When claiming damage to property, you’ll probably need to show a receipt to establish the value of an item. Submitting a handwritten receipt is an obvious red flag since there is no way to determine whether the number you’ve listed is accurate. Behavior can also be suspicious. For instance, a recent increase to your insurance coverage looks highly suspect when a claim follows shortly after. 

Many adjusters also look to social media postings to get to the bottom of a fraudulent claim. A person filing for disability coverage might claim that he or she is no longer able to work due to an injury or illness. However, if the same person is seen on social media partaking in strenuous activity, the adjuster could use it as proof that disability coverage is not necessary. Remember, social media postings are admissible as evidence in court. 

A person’s history with the insurance company can also provide specific clues. If you’ve made lots of claims in the past, new claims are likely to be scrutinized. While insurance is in place to protect you against unforeseen occurrences, making too many claims still looks suspicious. You’ll also be subject to investigation of your actions fall outside the norm when compared to the data insurance companies keep on customers.