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10 Ways Insurance Agents Spot Fraudulent Claims


9
Check List of "Suspicious Loss Indicators"
Handwritten receipts for repairs can sometimes be indicators of fraud.
Handwritten receipts for repairs can sometimes be indicators of fraud.
©iStockphoto.com/whitemay

The National Insurance Crime Bureau (NICB) -- did you even know there was one? -- has developed a super-secret list of 23 "suspicious loss indicators." These are items within a claim or its circumstances that signal the claim may be fake. Bogus. A rip-off. OK, the list really isn't "super secret," but a lot of the people submitting fake claims don't realize this list exists, and that it may lead to their downfall [source: Theim].

Here are just a few of the suspicious loss indicators insurance agents look out for:

  • A claimant who's totally calm and unflustered after submitting a large claim
  • A claimant who submits handwritten receipts for repairs on a covered item
  • A claimant who adds or increases homeowners or auto insurance coverage shortly before submitting a claim
  • A fire-damage claim for a home or auto where the fire started immediately after a family argument, or shortly after family members left the home/car
  • A medical claim submitted by a seasonal employee whose job is ending

Of course, some of these scenarios can be present in legit claims. But don't worry. Insurers know they're not positive indicators of fraud -- just possible ones -- and definitely signs they should further investigate certain claims [source: Theim].


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