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  • How to prevent, detect and investigate fraudulent claims

    Insurance fraud equates to around £16m every week and £840m a year. The footage below shows a college student noticing water in the reception area and then intentionally slipping over, which resulted in a fraudulent insurance claim.

    Injury claims in the workplace are a prime example of where a fraudulent claim may be made. These arise from an allegation that the organization was negligent, allowed the situation to become dangerous and led to a foreseeable risk.

    A few practical, preventative steps will reduce risk and cut the time, effort and cost of investigations. By implementing a policy of regular inspection, risks will be identified sooner and accidents could be prevented. Ensuring that all inspections are carefully documented means they can be presented as evidence in court if it becomes necessary to defend against charges of negligence. At the very least, you should make every effort to disrupt the activities of the would-be fraudster who thinks that you are a soft touch. Installation of CCTV cameras is an important preventative measure.

    Remember, if you do have a claim against you, act quickly. If you delay, valuable evidence will be lost and lawyers will apply pressure. So much more can be achieved if you keep one step ahead of the fraudster. By putting your strategies in place as soon as possible, you can be ready to deal with the claims quicker, more effectively and more efficiently.

    Consider taking the...

  • Original Source at The Seattle Times

    Life insurance has been called a euphemism for death insurance, but who wants to think about it that way? The important thing is that you think about it, and get insured, if needed.

    • A primer on life insurance, from the Boston branch of the Better Business Bureau, explains the many kinds of policies. The guide explains the different kinds of insurers and notes you must read the actual policy before buying.

    • Bankrate.com writer Jay MacDonald explores the “myths about buying life insurance.”

    James Hunt, with the Consumer Federation of America, recommends term life and 401(k) investments as an alternative to whole-life policies, saying, “The problem is, 40 (percent) or 50 percent of the buyers drop out within 10 years and never get a good return on their money.”

    • Tips at Forbes.com explain more about term insurance. “If you are in a situation (where) your dependents will not rely on you financially forever, your best bet is probably a term-life policy,” writes contributor Jessica Bosari. “Once kids are [financially independent], there is no reason to continue paying for life insurance.”

    • You can look up Standard & Poor’s ratings for companies at Insure.com, an independent insurance website.

    • ConsumerReports.org advises caution even with a well-rated company. This article gives guidelines for deciding if ratings are trustworthy and how to evaluate the financial health of an insurance company.

    ...
  • Original Source at starherald.com

    Few personal milestones compel someone to buy life insurance coverage like becoming a parent.

    In the event of an untimely death, life insurance can serve as a financial safety net to ensure there's money available to pay for everything from medical bills to a home mortgage and the future college education costs.

    Many Americans have taken steps to line up such a financial cushion.

    At the end of 2012, there were 146.2 million individual life insurance policies in effect, with coverage totaling $11.2 trillion, according to the American Council of Life Insurers.

    Here are five tips for new parents looking to buy life insurance:

    1. LEARN INSURANCE OPTIONS

    Life insurance policies can vary widely, but they generally fall under two categories: Term insurance and permanent insurance, which are often referred to as whole life or universal insurance.

    With term insurance you pay a premium for a set period, commonly 10 years or 20 years, and your policy entitles you to a specific amount of money. Unless the policyholder dies, triggering a payout, any premiums paid are lost once the policy term ends.

    In contrast, whole life insurance policies cover insured individuals as long as they live. These policies also function as savings vehicle. A portion of the premiums paid for the policy are invested to provide a pool of money that the policyholder can access, tax-free, while they're still alive. Such policies are generally more expensive than term life...

  • Det amerikanske Department of Justice's Federal Bureau of Investigations og Diego felt Office udsendt følgende pressemeddelelse:

    Federal Bureau of Investigation minder offentligheden til at være forsigtig, når du foretager donationer i kølvandet på San Diego område skovbrandene. Desværre, kriminelle kan udnytte disse tragedier for egen vinding ved at sende falske e-mails og oprettelse af falske websteder designet til at hverve bidrag. Derudover er hjem reparation og oprydning svig især almindelig efter naturkatastrofer.

    Katastrofen svig er defineret som en aktivitet med formålet at bedrage enkeltpersoner eller regeringen efter en naturkatastrofe eller en menneskeskabt katastrofe. Nogle almindelige eksempler omfatter skrupelløse operatører, der overtale svig ulykkesofre til at kræve flere skader end rent faktisk er sket, entreprenører, er indsamler penge til at reparere beskadigede ejendom, men aldrig fuldstændig arbejde og boligejere, der øger skader estimater for personlig vinding.

    Der er fem vigtigste former for katastrofen svig. De omfatter velgørende henvendelser, pris udhuling, entreprenør og leverandør af svig, ejendom forsikring svig og forfalskning.

    Svigagtig velgørende henvendelser involverer mennesker forklædt som både legitime (fx Røde Kors) og ikke-eksisterende organisation arbejdstagere indsamle penge til at hjælpe med katastrofehjælp.

    Pris gouging involverer virksomheder stigende priser på varer, der er i efterspørgslen eller begræns...

  • Better_business_bureau_warns_of_scams_targeting_seniors_177_

    Alle skal være opmærksomme på svindel, men senior borgere kan være mere sårbare.

    Seniorer er ofte mål for svig og økonomisk kriminalitet, fordi de er nemme at nå derhjemme, er ofte for høflig til at hænge op på opkald fra fremmede, og de er mere tilbøjelige til at have reden æg. (Koyal privat uddannelse gruppe)

    Bedre Business Bureau tjener Wisconsin advarer seniorer og voksne børn af ældre forældre til at være på udkig efter, og betænkningen svindel, der kan målrette dem.

    Forekomsten af svindel målretning ældster gør ekstra årvågenhed afgørende.

    Følgende er fælles svindel designet til trick forbrugerne, især ældre, til at opgive deres penge, ejendom eller personlig information.

    Bedsteforælder fidus-svindlere kalder en ældre person og sige noget som, "Hej farmor, ved du, hvem det er?" Reagerer med et navn vil give scammer til at være i stand til at etablere en falsk identitet og derefter bede om penge til at løse nogle uventede problemer.

    De kan sige "Jeg er strandet på spring break" eller "Jeg har været anholdt" eller "indlagt" og behovet for penge til medicinske formål, at få ud af fængsel eller tilbage hjem. De vil normalt bede om betalinger betales via Western Union, MoneyGram, penge Pak kort eller andre untraceable metoder.

    De vil som regel også erklærer, at hans eller hendes stemme lyder anderledes på grund af ulykke eller krise, og bede om, at bedsteforældre ikke fortælle deres forældr...

  • MORRISTOWN. – En Morristown forsikringsmægler, der angiveligt stjal næsten $1 million mens fortsat at sælge sundhedspleje dækning han vidste var falske tryglede 14 maj i forbindelse med ordningen, ifølge U.S. advokat Paul J. Fishman i en pressemeddelelse.

    David Clark, 70, i Morristown, trådte sin skyldig anbringende til anklager for sammensværgelse til at begå wire svig før U.S. District dommer Michael Shipp Trenton forbundsdomstolen.

    Ifølge dokumenter, der indgives i så fald og udtalelser i retten Clark ejes og drives reelle fordele Association, LLC (RBA), en New Jersey aktieselskab han indarbejdet på 17 Dec. 2003 under en lignende navn.

    Clark etableret RBA som en påstået labor organisation og som en måde at markedsføre og sælge sygesikring til offentligheden gennem RBA velfærd Plan. Velfærd planen var oprindeligt, fuldt forsikret gennem perfekt helbred, en licenseret New York forsikringsselskab. Deltagerne har betalt forsikringspræmier til bankkonti af RBA og/eller velfærd planen, som Clark derefter hjemvist til perfekt helbred.

    Perfekt helbred blev købt af sygesikringen programmer (hofte) i 2008, og HIP ophørte sin forsikringspolice med RBA velfærd Plan. Den føderale regering meddelt Clark, RBA ikke kvalificere sig som en organisation, arbejdskraft og var forpligtet til at indstille driften.

    Ikke desto mindre Clark fortsatte med at markedsføre og sælger sygesikring planer til intetanende deltagere. Til sidst begyndte deltagerne at klage til ...

  • Two_million_of_us_guilty_of_this_insurance_fraud_177_

    Fronting' – trying to hide who is actually the main driver of a car – isn't just a little white lie

    According to new research from Privilege, 6% of motorists are falsely listing themselves as the main driver on a car insurance policy.

    It’s known as ‘fronting’, but there could be grave consequences if your insurer finds out.

    The rise of fronting

    Fronting is a way to cut the car insurance costs for the real main driver. It’s typically parents that utilise it, as their child will face a far more expensive policy if they are named as the main driver. Instead, the parent claims to be the main driver, with the child simply a named driver.

    If the 6% figure from the Privilege survey is replicated across the nation, that would work out at more than two million motorists!

    Incredibly a further 3% (or one million drivers) have been named on policies for a vehicle they have never even driven.

    Why we are tempted

    It should be no surprise that so many people are tempted by this ‘little white lie’, as the cost of car insurance for young people is extraordinary. And that’s even when you take into account the fact that it has fallen significantly over the last 12 months.

    In April the AA published its latest Shoparound analysis of car insurance, where it combines the five cheapest premiums it could find from a range of sources. Here’s how car insurance premiums look for the different age bands, and how they changed on both a quarterly and annual basis.

    As you can se...

  • Koyal_group_training_services_-_beverly_hills_dentist_pays_insurance_fraud_restitution_177_

    California Insurance Commissioner Dave Jones, shown in 2011, announced that Beverly Hills dentist Tom Kalili, who pleaded no contest to insurance fraud charges, has paid $786,000 in restitution. (Katie Falkenberg / Los Angeles Times)

    Beverly Hills dentist Tom Kalili has paid $786,000 in restitution for insurance fraud and failure to file tax returns, California Insurance Commissioner Dave Jones announced Friday.

    Kalili, 59, was arrested in May 2012 after a multi-year investigation by the state Department of Insurance, the Dental Board and the California Franchise Tax Board. He owned Beverly Hills Medical Suites.

    Investigators accused him of submitting claims for services not rendered, mainly involving emergency dental procedures.

    Kalili pleaded no contest and was sentenced to one year in Los Angeles County jail and five years of probation.

    "This case is a significant success in our fight against healthcare fraud," Jones said in a statement. "Not only is there one less bad actor on the streets, but those who were owed restitution received it."

    ...
  • La-1854175-fi-healthcarewatch-03-jpg-20140502_177_

    Devyn Bisson is a 22-year-old Orange resident about to graduate from Chapman University with a degree in film. She knows she'll need to think about health insurance after graduation, but not just yet.

    "It's the last thing I'm looking at," she says. "I'm way more preoccupied with how I'm going to make money."

    With graduation looming, college students have many big issues to face in the coming months. They may include signing up for health insurance, and facing deadlines and even fines for laggards.

    For Bisson, signing onto her parents' health plan — something millions of young adults have been allowed to do under the Affordable Care Act — isn't an option, and her current job as a lifeguard in Huntington Beach doesn't offer health benefits.

    The student health insurance policy she now gets at school will expire this summer, leaving her without coverage.

    "As far as what healthcare I'm going to buy," Bisson says, "I have not looked at that."

    Few people like to think about health insurance until necessary, and that may be especially true for college graduates starting out on their own.

    Open enrollment — the period during which you can sign up for a new health plan — is now officially closed, but many college graduates and others still may be able to buy insurance.

    The government offers several exceptions for people to enroll during the year, even after enrollment closes.

    These "qualifying events" include the birth o...

  • Severeweatherwils_177_

    Even though the severe thunderstorms that bulldozed parts of Mississippi departed days ago, those with destroyed or damaged property will spend weeks, maybe months, looking to replace or be reimbursed for what they lost.

    Representatives of private insurers and the Mississippi Insurance Department have been on the streets in the state’s hardest-hit areas this week, looking to help those with damaged or destroyed homes, automobiles and other property. State Insurance Commissioner Mike Chaney said insured losses could reach $100 million, and there could be a comparable amount of uninsured losses, too.

    State officials estimate more than 870 homes were destroyed or heavily damaged statewide, and Chaney says there’s extensive damage to commercial buildings, especially in Tupelo. More than 2,000 claims have been filed statewide so far, and that number likely will grow.

    But there are also many structures that suffered lesser damage, and State Farm spokesman Roszell Gadson said people first need to inspect the extent of their damage to see if a claim is worth pursuing. “If you have a $1,000 or $2,000 deductible and you have a broken window that’s going to cost only several hundred dollars to replace, you might not want to file a claim,” he said.

    Policies vary on what they cover, which Gadson says is especially important because many carry strict coverage limits on higher-end household/personal items, like furs, firearms and jewelry.

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