Filed Under:Claims, Investigative & Forensics

NYC PIP Claims Costs Outpace Inflation

Medical Cons, Fraud Drive Costs Up 70 Percent

Crooked medical providers and dishonest drivers continue to bilk New Yorkers and their insurers, exposing numerous dents in the state’s no-fault-based system.

Riddled with fraud, “creative” medical billing for procedures and services, and needless lawsuits, the system has been under fire for years. A recent analysis of thousands of PIP claims logged last year may boost the efforts of those lobbying for state-wide personal injury protection (PIP) reform.

“This report further details the problem of claims abuse in New York, especially unscrupulous medical providers who overtreat and overcharge claimants and their insurers,” said Elizabeth Sprinkel, senior vice president of the IRC. “Even when the excessive charges can be mitigated, the costs of combating these fraudulent activities are further driving up the price of insurance for all consumers in the state.”

Although soaring costs are most pronounced in New York City, where drivers pay as much as 272 percent above the state average, the IRC was quick to identify Brooklyn and Queens as hotspots for this type of abuse. More than half (52 percent) of apparent abuse claims stemmed from accidents occurring in either Brooklyn or Queens; these two boroughs accounted for only 28 percent of all claims in the study. Consequently, in Queens drivers pay 167 percent more than the statewide average, whereas Brooklyn residents pay 185 percent more.

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