Private investigator
Edward Saucerman parlays 16 years of law enforcement experience into his current venture as the President and Qualified Manager of The Titan Group, Professional Investigations. In that capacity, Mr. Saucerman performs an array of investigations, including fraud evaluations. Multiple kinds of fraud exist, and Edward Saucerman provides the following information about insurance fraud.
1. Many behaviors compose insurance fraud. As a matter of fact, some consumers are shocked to see actions they do without thinking actually constitute defrauding insurance companies. For instance, underrepresenting how many miles you drive to work each day constitutes fraud, as does staying off work on a workers’ compensation claim, even after your doctor has cleared you to return.
2. A 2003 Accenture, Ltd. survey showed that about 24 percent of respondents felt it was somewhat to quite acceptable to defraud insurance companies.
3. The ultimate cost for such fraud does not lie with the insurance companies. Those corporations pass those costs onto the consumer in the form of higher insurance premiums. Insurance fraud costs each consumer about $200 to $300 extra each year.
4. Medicare, Medicaid, and workers’ compensation fraud all cost the taxpayers significant amounts of money.
5. Insurance fraud is a felony. In 2007, Federal Bureau of Investigation (FBI) fraud cases led to nearly 700 convictions and more than $1.1 billion in ordered restitution.
6. Fraudulent behaviors include, but are not limited to overreporting the cost of injuries and property damage, making claims for items that were not stolen or destroyed, billing for medical services not provided or unnecessary treatments, using your health insurance to obtain medication for another (drug diversion), misclassifying employees in high-risk jobs as being in low-risk occupations, misclassifying employees as independent contractors for the purpose of workers’ compensation, staging accidents for insurance compensation, and filing erroneous Medicare claims for durable medical equipment. These are just a few of the many types of insurance fraud.
7. A 2008 Coalition Against Insurance Fraud survey showed that 20 percent of Americans feel it is perfectly acceptable to defraud insurance companies under certain circumstances. Additionally, Accenture’s 2008 insurance survey showed that more than 76 percent of respondents said they would be more likely to commit insurance fraud during an economic downturn.