Fraud Opportunities Rise

“Does a bad economy increase crime?  Analysts have debated that question for years, according to Mike McKee, senior special agent for the National Insurance Crime Bureau.  While it’s too soon for statistics to confirm whether recent events like the mortgage meltdown and an increase in unemployment truly lead consumers to commit more crimes, McKee said at least anecdotally the economic recession is affecting insurance fraud.”

 

Different types of fraud and the opportunity to commit fraud has taken a toll on all lines of the insurance business according to fraud bureaus. 

 

Commercial insurance is being hit with the rise in theft of cargo as electronics and other equipment are taken right off the trucks.  Circuit breakers are being ripped out and copper wiring is increasingly stolen from commercial buildings.  

 

An increase in vehicle giveups has been reported when owners dispose of a vehicle and then claim that their vehicle has been stolen.  Then the owner collects the insurance money and often makes a profit.  Employees of car dealerships are sometimes involved in the theft and/or burning of the vehicle.  And in turn, the owner may purchase a new vehicle as payoff for the help of the dealership employee. 

 

Workers’ Compensation and health insurance carriers have noticed that people are staying out of work longer and claiming more injuries.  Instead of a hurt arm, now it is an arm and a leg, or back and a shoulder.  The most attention-grabbing trend is employees extending their claim.   In one case, for example, an employee injured his toe, which led to not being able to sleep, then led to sexual dysfunction.   As a result, he had to have sleep and sex therapy along with treatment for the injured toe. 

 

The loss or disappearance of classic cars and jewelry has risen.  Arson of both homes and vehicles has also increased.  Consumers are burning their homes hoping for an insurance bailout.  Others are claiming smoke and ash cleanup from wildfires to get insurance payoffs. 

 

Another major inclination is in medical identity theft and provider fraud.  In this situation, a person’s identity along with their medical and insurance information is stolen and fraudulent bills are sent to the insurance company.  Then the insurance company pays the bills to a fraudulent company, while the true insured and his insurance company are unaware that they are victims of a scam.

 

And unfortunately, there is a rise in insurance agents who are committing premium theft and diversion.  They divert premium checks that are intended for the insurance companies and embezzle them to use for personal use while assuring the insured they are covered. 

 

Source:    Insurance Journal, April 2009, Patricia-Anne Tom http://www.insurancejournal.com/news/national/2009/04/14/99585.htm

Employee Dishonesty Insurance: What Is It & Why Do I Need It?

I was talking to a client the other day, and he asked me what employee dishonesty was all about. He owns a small business with about 6 employees, and most of them have been with him for at least 5 years. He didn’t understand why he needed it since he trusts them.

What Is It?
Employee dishonesty is considered to be a criminal at committed by and employee acting alone or in collusion with others. There must be intent by the employee to cause the employer a loss and to obtain a financial benefit for the employee or someone else.

Why Do I Need It?
Recommend Employee Dishonesty coverage to most employers, and their first reaction is usually: “I don’t need that. My employees have been with me for years and we’re like family!”

Unfortunately, incidents of Employee Theft are on the rise. Following are several incidents that have happened within the last few months:

BEAUFORT, SC: A box office manager was charged with stealing over $98,000 from a performing arts center. During an internal audit it was discovered that the manager had been writing checks for personal use since 2006. — The Beufort Gazette, 06/08

BEAUFORT, SC: A Beaufort County motor-grader operator was arrested for stealing over $35,000 in diesel fuel (approximately 10,000 gallons). Between March, 2007 and mid June, 2008 the operator was filling his county issued pickup, that has an 80 gallon tank, with diesel fuel from county-owned pumps and then selling the fuel to others. — The Beaufort Gazette, 06/26/08

MYRTLE BEACH, SC: A woman working for a local construction company was arrested after it was discovered she had written over $260,000 in checks over a 5 year period to pay her personal expenses. — The (Myrtle Beach) Sun News, 10/08/08