Filed Under:Claims, Investigative & Forensics

Calif. Responsible for One Fifth of US QCs in Past 3 Years

In the last three years, Calif. has seen a 9-percent increase in the number of questionable claims (QCs) reported, according to the National Insurance Crime Bureau (NICB). Dominated by questionable vehicle thefts and faked/exaggerated injuries, these QCs are referred to the NICB by the more than 1,100 member insurance companies and require at least one (and as many as seven) indicators of possible fraud.

The claims in Calif. made up nearly 50,000 of the 250,350 QCs across the country between 2008 and 2010, though were few in comparison to the 235,000 claims reports that are submitted to ISO daily.

When it came to policy type for California QCs, the most common (54 percent) was personal automobile, with other common policy types being personal property, workers’ compensation and employer’s liability, and commercial automobile.

The most frequently used referral reasons for these QCs were questionable vehicle theft and faked/exaggerated injury followed by fictitious loss, prior loss/damage, and faked damage. Additionally, the most common overall QC loss types were bodily injury, theft, collision, bodily injury relating to automobiles, and vandalism and malicious mischief.

The cities posting the largest number of QCs were Los Angeles, San Francisco, San Diego, Sacramento, and San Jose, comprising nearly 25 percent of QCs from 2008 to 2010. In all three years, Los Angeles far outweighed the other cities with between 1,500 and 2,000 QCs each year. Even in second place San Francisco, between 500 and 650 QCs were reported annually.

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