Those spearheading the fight against insurance fraud report that the past few years began with an influx of suspicious cases. During the first quarters of 2009-2011, the number of questionable claims (QC) referred to the National Insurance Crime Bureau (NICB) for further investigation increased 23 percent, with the most significant uptick in medical-related claims.

That's according to the Des Plaines, Ill.-based organization's first-quarter 2011 ForeCast report, which analyzes referrals submitted by its more than 1,100 property and casualty (P&C) insurers and self-insured member organizations. In the report, NICB showed that the first quarter of 2009 brought in a total of 19,967 QCs, compared with 24,497 received in the first quarter of 2011—for a 23 percent overall increase.

NICB categorizes suspicious claims as property, casualty, commercial, workers' compensation, vehicle, and miscellaneous. The 1Q report findings indicated that property QCs were up 3 percent, while casualty and commercial QCs rose by 25 percent and 21 percent, respectively. Workers' compensation QCs increased 24 percent, and there was a 25-percent swell in miscellaneous claims.

With the exception of vehicle claims, which were down by 4 percent, all other categories were up, most notably those pertaining to medical-related claims. The fact that medical-related claims continue to pose headaches for insurers comes as no surprise to NICB President and CEO Joe Wehrle, who explained that NICB has allocated its ample investigative and analytical resources accordingly:

Recommended For You

Want to continue reading?
Become a Free PropertyCasualty360 Digital Reader

Your access to unlimited PropertyCasualty360 content isn’t changing.
Once you are an ALM digital member, you’ll receive:

  • Breaking insurance news and analysis, on-site and via our newsletters and custom alerts
  • Weekly Insurance Speak podcast featuring exclusive interviews with industry leaders
  • Educational webcasts, white papers, and ebooks from industry thought leaders
  • Critical converage of the employee benefits and financial advisory markets on our other ALM sites, BenefitsPRO and ThinkAdvisor
NOT FOR REPRINT

© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.