Companies can easily fall victim to insurance fraud schemes, such as slip ’n’ falls, fake car accidents, etc. Scam artists rely on these tactics because they are sometimes difficult to disprove and can often lead to big payoffs. However, there are steps you can take to protect your business from the premium hikes and litigation that follow a fake insurance claim.
Slip ’n’ fall fails
Here’s how an insurance scam might play out. A woman states that she slipped on a wet sidewalk outside a business and that the fall caused injuries that ultimately led to a miscarriage. She claims that the business’s owner had failed to maintain the premises or warn her of any danger. The woman provides an emergency room report documenting the miscarriage and demands a $75,000 settlement.
Later, when the business’s insurance company orders the woman’s medical records directly from the hospital, there’s no mention of a miscarriage. It’s determined that she has falsified the report and that her claim is fraudulent.
Unfortunately, insurance companies can’t always expose false claims. This type of fraud succeeds all too often because there’s no reliable evidence to disprove it.
First and best defense
A security camera system is recommended because it can help you monitor activity on your premises and capture fraud evidence. But employees are your company’s first and best defense. Train them to respond properly to accidents by photographing the site immediately and then collecting and documenting the:
- Date, time and location of the accident
- Name, address, phone number and date of birth of any injured person
- Nature of injuries reported
- Names, addresses and phone numbers of witnesses
- Weather conditions at the site (if outdoors)
- Description and chronology of the incident
- Description of any injured person’s appearance and attitude
All accidents should be reported to your company’s insurance carrier, along with any suspicious behaviors or comments employees witnessed. And include the warning signs of common insurance schemes in your company’s fraud prevention program.
If you suspect that your business was targeted with an insurance fraud incident, JLK Rosenberger can help. For more information, call us at 949-860-9902 or click here to contact us.