Rank |
Type of insurance |
2010 |
2011 |
Percent change
2010-2011 |
1 |
Miscellaneous (1) |
67,247 |
78,039 |
16% |
2 |
Casualty (2) |
46,741 |
54,003 |
16 |
3 |
Workers compensation (3) |
4,231 |
4,773 |
13 |
4 |
Vehicle (4) |
34,585 |
35,652 |
3 |
5 |
Property (5) |
15,853 |
16,227 |
2 |
6 |
Commercial (6) |
1,940 |
1,937 |
-0.2 |
|
Total questionable claims |
91,797 |
100,450 |
9% |
(1) Miscellaneous: includes premium avoidance, medical provider, agent/adjuster, attorney, medical provider, organized ring and vendor fraud; and other causes.
(2) Casualty: includes duplicate, inflated, and services not rendered billing; faked/exaggerated and prior injuries; staged/caused, jump-in, and slip and fall accidents; solicitation; improper facility/provider license; excessive treatment and unbundling or upcoding.
(3) Workers compensation: includes duplicate and inflated billing; prior injury/not work-related; false social security number, false loss, working while collecting and other claimant causes; employer misrepresentation and other premium fraud and other causes.
(4) Vehicle: includes hail, faked, water/flood and suspicious fire/arson damage; odometer, owner give-up and auto glass fraud; paper/phantom accident; VIN manipulation; auto repair/body shop fraud and other causes.
(5) Property: includes flood/water, hail and inflated damage; suspicious disappearance/loss of jewelry, suspicious theft/loss excluding vehicle; and fire/arson.
(6) Commercial: includes farm, construction/farm/heavy equipment, cargo, fire/arson, vehicle and other theft loss; slip and fall; suspicious object in food; product liability; and other causes.
Source: National Insurance Crime Bureau. |