It's no secret that fraud in the property/casualty realm is a rampant problem. Whether it's hard fraud involving staged auto accidents or property arson or soft fraud that is opportunistically executed by a claimant who exaggerates a legitimate claim, fraud is a crime the Insurance Information Institute estimates costs the property/casualty industry more than $30 billion in 2005 and also is responsible for increasing aggregate policyholder premiums.
What often is not talked about, however, are the cases involving claim adjusters who cross over into the criminal realm and conspire to benefit from their positions, blurring the line between the opportunity and forethought definitions of hard and soft fraud. Just how prevalent this problem is remains unclear, but here are a three cases involving claim adjusters who tried to work the system and failed:
Terrance A. Tasker was a claim adjuster for Nationwide Insurance and treasurer of his choir group called Unlimited Praise. According to information from U.S. attorney Rod J. Rosenstein, however, Tasker created fake claimants for claims he was investigating. The scheme involved transmitting electronic payment authorizations to Nationwide in Columbus, Ohio, directing payment to the fictitious claimants. Under Tasker's instructions, Nationwide sent 47 checks totaling more than $118,000 to a post office in Maryland from March 2001 to November 2003, where he would endorse the checks in the name of Unlimited Praise and deposit them into the choir's bank account. Tasker then would withdraw the deposited money for his own personal use or write checks from that account to credit card companies for balances owed by him. He faces 10 years in prison and a $250,000 fine.
Karla E. Biven used to work for the Maryland Automobile Insurance Fund as a claim adjuster. According to a statement from the Maryland Attorney General's Office, she had a habit of adding fictitious claimants to legitimate auto accident claims. Once a settlement was achieved, Biven disbursed the fraudulently obtained money to an acquaintance in at least two separate instances for amounts totaling more than $7,000. Her activities were discovered after an internal audit by the Maryland Automobile Insurance Fund. She was ordered to serve 60 days of probation, make full restitution to her former company, and serve 24 hours of community service.
Tracy Parrish worked as a casualty claim adjuster in Virginia for Nationwide. According to the Virginia State Police Insurance Fraud Program, she embezzled more than $21,000 from her employer, issuing 52 fraudulent checks to 44 different recipients over the span of seven months. Each check was issued for an amount slightly under or equal to her check-writing authority limit of $500, and an investigation proved that most of the checks were made out to actual claimants. However, Parrish kept the checks, forged the claimants' and her husband's signatures, and deposited them into her husband's checking account. On top of that, 17 were made payable to Parrish, her family members, or variations of their names. She was sentenced on six felony charges and ordered to make full restitution to her former employer. She also received a 10-year sentence, suspended for 20 years with good behavior, for the embezzlement charge.
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