S.C. AG: Auto insurance fraud a $12M problem

Jessica M. Karmasek Jul. 12, 2011, 11:53am


COLUMBIA, S.C. (Legal Newsline) - South Carolina Attorney General Alan Wilson, in an annual report released last month, said nearly $12 million in auto insurance fraud was reported in the state last year.

Bogus vehicle claims, according to the report, accounted for more than half of last year's insurance fraud complaints.

Wilson says defrauding insurers means more than just ripping off a company. It also causes increased premiums for policyholders and makes it more difficult for those seeking coverage to find affordable auto insurance quotes online or in person.

According to the Attorney General's Office, coverage fraud costs the average U.S. household more than $1,000 a year in out-of-pocket costs.

In South Carolina, last year's total insurance fraud -- including health, workers' compensation, auto, disability, life and personal or commercial property -- more than doubled from the year before to nearly $14.5 million.

The state's figures mirror reports nationwide.

Last month, the National Insurance Crime Bureau reported a 23 percent increase from 2008 to 2010 in the number of "questionable claims" referred to it by member insurers for review and investigation of possible fraud.

In South Carolina, where the NICB reported 1,452 questionable claims last year, ranked 17th nationwide for questionable claims, up from 18th in 2009 and 19th the previous year.

Fraud, Wilson says, can be as simple as misrepresenting facts on an insurance application or "padding" or inflating actual claims. Or it can be as serious as submitting claims for injuries or damage that never occurred, or even "staging" accidents.

According to the Attorney General's Office, seven of the most common types of insurance fraud include:

- Under reporting the number of miles you drive on your auto policy;

- Failing to report an accurate medical history when applying for health insurance;

- An employee of a company who fakes or exaggerates injuries to avoid work and draws workers' compensation payout;

- An auto accident victim who falsifies or overstates injuries -- or even fakes the accident -- to achieve a large settlement or award;

- Staging automobile accidents which result in inflated injury claims;

- An insured who draws accident and health insurance benefits because of exaggerated or even fabricated injuries or illness; and

- Exaggerating the amount and value of items stolen from a home or business.

"Research indicates that the public's attitude about insurance fraud has grown increasingly tolerant in recent years," Wilson said in a statement. "Studies show that 1 in 3 Americans believe it is 'all right' to pad claims to make up for premiums paid in previous years when they had no claims. Most people think that fraud is a victimless crime, but you are the victim.

"Insurance fraud directly affects the amount you pay for health, auto and homeowner's insurance and increases the prices you pay for goods and services."

To help stamp out insurance fraud and hold down premiums, the Attorney General's Office has announced the creation of a new program, the South Carolina Insurance Fraud Hotline.

The hotline is available 24 hours a day and callers do not have to reveal their identity when reporting fraud, Wilson's office said.

From Legal Newsline: Reach Jessica Karmasek by e-mail at jessica@legalnewsline.com.

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