There's never quite enough time in the day. So, like the claim professionals for whom we write, I multitask out of necessity. One tool I've found helpful is the Google Alert. A simple idea, the Google Alert is a way to get information from the web sent directly to your inbox. Enter a few key words — mine are "adjuster," "claims," and "property and casualty" — and you are ready to click and absorb the zeitgeist of the industry.
Besides helping me stay on top of industry news, the other great thing about Google Alerts is the variety of viewpoints that wander in each day, vying for my attention. One recent alert that caught my eye involved a man who was discussing an auto accident, one in which he was not at fault. In his blog entry, he noted that he was not injured, although he mentioned that he had been dealing with increased knee pain due to an upcoming knee replacement surgery unrelated to the accident. He further noted that the other driver's insurance was handling all of the repairs as well as his car rental.
However, his next few statements — words that could be read by anyone and everyone with an Internet connection — blurred the heretofore black-and-white nature of the claim: "My question is, since the insurance company is paying for all repairs and the rental — and I didn't need to seek any medical treatment stemming from the accident — do I have the right (or should I) seek some form of compensation for the PIA that this accident has been?" [PIA stands for pain in the ... well, you get the point.]
I'm sure our anonymous friend was feeling put out by the reckless behavior of someone that had resulted in inconveniencing him. Who can blame him? But then he states the following: "So if you're an insurance adjuster and can give an honest opinion and not just the company line, I'd like to hear from you. Bear in mind, I'm not looking to get rich, but a little extra cash … wouldn't hurt."
A little extra cash wouldn't hurt. How many times has an adjuster heard that one? I suppose it wouldn't hurt him directly, unless he was caught and convicted of the fraud he is proposing. But paying out beyond indemnity sure hurts someone. According to recent study by the Insurance Research Council, fraud and buildup add between 13 and 18 percent to auto injury claims. That's up to $6.8 billion, folks, and it's just counting the auto line. Not exactly chump change.
A lot of people out there want to challenge the accuracy of fraud statistics and the industry's willingness to trot them out despite the fact that it cannot support the numbers with hard data. They're right, to an extent. After all, how can one assign a value to a crime that was not caught? However, that doesn't mean fraud is a crime conjured up by insurers. Moreover, it certainly doesn't mean there are a minority out there who view padding a claim as a chance to balance out what they feel is a losing bet in the form of paying monthly premiums.
Adjusters cannot treat policyholders as perpetrators of fraud in every claim, nor should they. But neither should they attach blinders to the notion that many feel insurance fraud is a victimless crime, as the example of our auto accident victim above clearly illustrates. Given today's desperate economic climate, it's a situation I fear claim professionals can expect to encounter more of in the days and months ahead and as such, must be prepared to handle.
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