An Adjusters Guide to the Fight Against Insurance Fraud

insurance fraud

How much does insurance fraud affect all of us? The actual numbers may intrigue you. Per the FBI, insurance fraud costs the average U.S. family between $400 and $700 a year in increased premiums. Keeping in mind, the FBI’s $40 billion annual cost estimate doesn’t take into account health insurance scams. In a broader study, the Insurance Information Institute estimates … Read More

NYC Twelfth Jurisdiction Prohibits Credit Checks for Employment

Prohibits Credit Checks

It’s Affirmed, New York City Prohibits Credit Checks for Employment Purposes The New York City council passed a bill in April of 2015 that now prohibits credit checks for employment purposes when the employer has four or more employees. The NYC Coalition to Stop Credit Checks in Employment, a coalition of nearly 80 community, labor, civil rights, student, immigrant and legal services organizations, … Read More

A Near Perfect Recorded Statement

Perfect Recorded Statement Image

When someone is injured, or worse, when someone wants to give the appearance of an injury, the thought, details, and circumstances are usually not a well thought-out idea.  Especially if the injury was an actual injury and caused by a legitimate accident.  Nothing is well-thought out in a spontaneous event, it’s the very definition of an accident, isn’t’ it?  Therefore, … Read More

Workplace Injury: Clumsy or Compensable?

Compensable or Clumsy Image

The mere fact that an individual suffers some sort of injury while at his place of employment is not sufficient to render the injury compensable. Under the South Carolina Workers’ Compensation Act, and the case law interpreting the Act, the Claimant must prove that the existence of two separate criteria. Specifically, to be compensable, an injury must be one “arising … Read More

Pretexting and the Law

Pretexting and the Law

The Pretext Pretexting, by definition, means a reason assigned to justify an act, which have only the appearance of truth, and which are without foundation; or which if true are not the true reasons for such act. In other words, a false reason or motive put forth to hide the real one. Pretexting is a powerful tool and for a … Read More

Video Camera Care

Video Camera Care Image

Video Camera Care 101 As a private investigator in the insurance industry, I don’t think it’s much of a stretch to assume your most toll-of-the-trade is your video camera. While we all may agree on this, not all of us give our most prized possession the “white glove service” our camera deserves.  Do you provide just the right video camera care? … Read More

Hackettstown Business Owner was Indicted

Hackettstown Business Owner Image

Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor announced that a Hackettstown business owner was indicted yesterday for misappropriating more than $300,000 in client funds – intended to fund the client’s employee health insurance plan – to support his ailing business. William Boudreau, 66, of Flanders, was charged by the state grand jury with second-degree … Read More

The TIG ALS Ice Bucket Challenge

Icebucket Challenge Image

TIG Donates $272 to Fight ALS The Ice Bucket Challenge, sometimes called the ALS Ice Bucket Challenge, is an activity involving dumping a bucket of ice water on someone’s head to promote awareness of the disease amyotrophic lateral sclerosis (ALS) and encourage that donations be made for research that will contribute to the eradication of this debilitating disease. It went … Read More

Roofer Gets Prison Time for Insurance Fraud

Columbus, Ohio announced roofer gets prison time for insurance fraud.  Terrance J. King, owner of Home Improvement Terrance King, which also did work in the Dayton area, has been sentenced to 48 months in prison and ordered to pay $241,000 in restitution. In November 2013, King pleaded guilty to money laundering, false claims, and filing a false federal income tax … Read More

Reported SC insurance fraud rising

BY BRUCE SMITH Associated Press – August 8, 2014 “SC Insurance Fraud Rising” Insurance fraud complaints in South Carolina have reached an all-time high, with more than 1,200 pouring in last year, according to a report released Friday by Attorney General Alan Wilson. The annual report from his office’s Insurance Fraud Division noted attorneys prosecuted cases that resulted in 37 convictions … Read More