Every P&C insurer has to deal with them (and occasionally life insurers, toosee Private Eyes Watch for Corpses that Blink, in the March 15, 1999, National Underwriter). Theyre what Mark Burnam, claims systems and operations manager for Kemper Insurances Individual and Family Group (IFG), calls opportunistic claimants.

Theyre the ones whose first reaction to a fender-bender is to grab their necks and shout Whiplash! hoping to get five-figure checks from Kemper IFG or some other insurer for soft tissue injuriesthe kind that cant easily be detected, or disproved, by a physician. Like every carrier, Kemper realizes some of these injuries are real and deserving of payment. Our job is to pay people what they are entitled to, Burnam said. But we dont want to pay what is not legitimately owed.

Differentiating between the two has never been easy and has often been expensive. Insurers have to bring in experts to examine the physical evidence from an accident and issue an opinion on the severity of the injury. That can be a costly proposition and often leads to acrimony between the claimant and the insurer, which in turn leads to a court date. This goes against the basic principle of claims settlement: You want to get in early and not let a $500 claim turn into a $10,000 claim, Burnam said.