Over the past three years, N.Y. has seen a 10 percent increase in suspicious claims, according to the National Insurance Crime Bureau (NICB). From 2008 to 2010, more than 20,000 questionable claim (QC) referrals were submitted to the NICB in New York.
A total of 7,026 QCs were filed in 2010, compared with 6,726 in 2009 and 6,378 in 2008. These claims are submitted because of one or more indicators of possible fraud by NICB member insurance companies.
In 2010, 83 percent of the QCs were related to personal automobile claims, just over the average of 80 percent for the three-year period. The three most common referral reasons were "faked/exaggerated injury," "excessive treatment," and "staged/caused accident."
All of this comes after the 2002 opening of the NICB's first Major Medical Task Fraud Force in New York. Because of its effectiveness, it has spread to six other cities, though there is a strong focus on the force in New York because of the large amount of fraud, according to NICB.
"One of the most important things that can be done to fight fraud in New York is to support the passage of S.2816 sponsored by Senator James Seward," said Joe Wehrle, NICB president and chief executive officer. "This bill would deliver comprehensive reform to [the state's] no-fault system while preventing much of the fraud we see conducted by illegitimate clinics and their patients—receiving treatments for non-existent injuries sustained during phony accidents."
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