NICB:10 States Show Uptick in Questionable Claims

Surges In Michigan, Ohio, Minnesota

The National Insurance Crime Bureau (NICB) has released the findings of ten state-specific reports charting questionable claims (QC) referrals for the past 2 years. All of the results share a striking commonality: an uptick in suspicious claims activity.

When evaluating the QCs originating from Ohio, Texas, New York, New Jersey, California, Minnesota, Michigan, Massachusetts, Illinois, and Connecticut during 2009, 2010 and 2011, the NICB observed rising numbers across the board, with increases ranging from 4 percent in Texas to 49 percent in Michigan. 

To view a state-by-state breakdown of QCs from 2009 to 2011 , select "Next" at the bottom right.

Although western states such as California and Washington have long been considered hot beds for  auto theft, the midwest accounted for a large portion of the total QCs, with Ohio and Illinois posting increases of 36 and 17 percent, respectively.

Member companies refer QCs to the NICB for closer review based on one or more indicators of possible fraud. A single claim may contain as many as seven referral reasons. Each state-specific report has been organized by loss city, core-based statistical area (CBSA), policy type, loss type, policy and loss type combined and referral reasons.

Highest Increase in QCs 

Of the ten states surveyed, Michigan logged the highest increase in QCs, with 49 percent. Detroit, Mich. was the loss city that reported the most QCs in each of the 3 years. Between 2009 and 2010, QCs in Detroit increased 30 percent, only to decrease the following year by 13 percent (between 2010 and 2011).

Michigan: 49 Percent

 

In 2009, there were 2,973 Michigan QCs referred to NICB from its member insurance companies. In 2010, the number increased to 5,023 and in 2011, it dropped to 4,434, which represented a 49-percent increase compared to the 2009 total.  

 

 

Following Detroit (1,341), Flint (88), Dearborn (86), Southfield (65), and Warren (64) reported the most QCs. The top five core-based statistical areas (CBSAs) reporting QCs were Detroit-Warren-Livonia, Flint, Grand Rapids-Wyoming, Lansing-East Lansing, and Ann Arbor. 

Leading loss types: personal injury protection (PIP), theft, collision, glass, and bodily injury.

 Ohio: 36 Percent

 

 

In 2009, the NICB received 1,924 Ohio QCs to review for possible fraud. In 2010, that number increased to 2,193 and in 2011, it rose again to 2,621—36-percent increase compared to the 2009 figure.

The Ohio city generating the most QCs last year was Cleveland, with 292 referrals. Trailing closely behind were Columbus (263); Toledo (238); Cincinnati (176); and Akron (105).

 

Minnesota: 31 Percent

 

In 2009, the NICB received 977 Minnesota QCs from its member insurance companies. In 2010, the Des Plaines, Ill.-based non-profit organization says that figure increased to 1,136 and then climbed to 1,278 in 2011 for a 31-percent increase over the 2009 activity.

The top five cities generating the most QCs last year were Minneapolis (314), St. Paul (156), Brooklyn Park (39), Bloomington (23), and Coon Rapids (18), all shown above. The top five CBSAs reporting QCs were Minneapolis-St. Paul-Bloomington, Duluth, St. Cloud, Rochester and Mankato-North Mankato.

Leading loss types: personal injury protection (PIP), bodily injury, theft, collision, and hail.

New Jersey: 26 Percent

 

 

In 2009, 1,509 NJ QCs were submitted to the NICB for closer examination. In 2010, the number increased to 1,412; in 2011, it rose again to 1,903, a 26-percent increase compared to 2009.

The top five cities in New Jersey generating the most QCs last year were Newark (131), Paterson (84), Elizabeth (81), Jersey City (73) and Irvington (48). The top five CBSAs reporting QCs were New York-Northern New Jersey-Long Island, Philadelphia-Camden-Wilmington, Trenton-Ewing, Atlantic City and Vineland-Millville-Bridgeton.

Leading loss types: bodily injury, personal injury protection, collision, other automobile, theft and property damage.

 California: 19 Percent

 

 

Between 2009 and 2011, the Los Angeles, Calif. metro area led the state in suspicious claims activity reported by NICB member insurers. Just last year, Los Angeles reported 2,440 QCs, more than any other Calif. city.

In 2009, there were 16,266 California QCs, which quickly rose to 17,092 in 2010. In 2011, the number of QCs swelled to 19,388—an increase of 19 percent from 2009.  

After Los Angeles, San Diego logged the highest number of QCs with 691, followed by San Francisco (576), Sacramento (515), and San Jose (496). The top five CBSAs reporting QCs were Los Angeles-Long Beach-Santa Ana, San Francisco-Oakland-Fremont, Riverside-San Bernardino-Ontario, San Diego-Carlsbad-San Marcos and Sacramento-Arden Arcade-Roseville. 

Leading loss types: bodily injury, theft, collision, vandalism and malicious mischief, and comprehensive.

Illinois: 17 Percent

 

 

NICB member insurers submitted 2,776 Illinois QCs for review in 2009. In 2010, the number rose to 3,509 and then dropped back to 3,255 in 2011. Last year's figure indicates an increase of 17 percent from 2009.  

The top five cities in Illinois with the most QCs last year were Chicago (1,240), Rockford (53), East Saint Louis (36), Peoria (30), and Aurora (28). The top five CBSAs reporting QCs were Chicago-Naperville-Joliet, St. Louis, MO-IL, Rockford, Peoria, and Springfield.

Leading loss types: bodily injury, theft, collision, other automobile, and workers’ compensation medical. 

 

To access the full reports, visit www.nicb.org. The NICB is the nation’s leading not-for-profit organization exclusively dedicated to preventing, detecting, and defeating insurance fraud and vehicle theft through data analytics, investigations, training, legislative advocacy and public awareness. More than 1,100 insurance companies comprising approximately 80 percent of the nation's P&C insurance organizations, as well as self-insured companies support the NICB.

 

 

 

Page 1 of 7
Comments

Resource Center

View All »

Complimentary Case Study: Helping achieve your financial goals By:...

Find out how a Special Investigation Union used TLOxp to save the company money and...

Do Your Clients Hold The Right CDL License?

Learn about the various classes of CDL Licenses and the industries that are impacted by...

Integrated Content & Communications: A Key Business Issue For Insurers

Insurers are renewing their focus on top line growth, and many are learning that growth...

High Risk Insurance Coverage in the E&S Market

Experts discuss market conditions, trends and projected growth in a rapidly changing niche.

Top E-Signature Security Requirements

This white paper covers the most important security features to look for when evaluating e-signatures...

EPLI Programs Crafted Just For Your Clients

Bring us your restaurant clients, associations and other groups and we’ll help you win more...

Is It Time To Step Up And Own An Agency?

Download this eBook for insight on how to determine if owning an agency is right...

Claims - The Good The Bad And The Ugly

Fraudulent claims cost the industry and the public thousands of dollars in losses. This article...

Leveraging BI for Improved Claims Performance and Results

If claims organizations do not avail themselves of the latest business intelligence (BI) tools, they...

Top 10 Legal Requirements for E-Signatures in Insurance

Want to make sure you’ve covered all your bases when adopting e-signatures? Learn how to...

Florida Insurance Monitor eNewsletter

Receive P&C insurance news and perspective on the market and regulations for Florida and the Southeast Region. Sign Up Now!

Advertisement. Closing in 15 seconds.