Maryland Auto is committed to preventing fraudulent claims. Our claim representatives are trained to identify suspicious loss indicators, or “red flags,” to determine if a claim warrants further investigation through our Special Investigations Unit (SIU).
Fraud can take many forms from altered facts of the accident to unrelated or exaggerated damages or injuries. When the investigation concludes that fraudulent factors are present, the claim is denied by our claims staff.
Occasionally, after the suspected fraudulent claim is denied, suit is filed. In these cases, Maryland Auto is well-prepared to defend our position. In many cases, the suspected fraudulent claimant does not appear for the trial, and the cases are often dismissed outright.
Recently, however, Maryland Auto took a claim to trial in which the injuries claimed were very questionable, and the claimant did appear for the trial. Our policyholder was involved in a minor accident with the claimant, who claimed to be rear-ended. The claimant contended that they suffered pain in their shoulders, neck, and back and were seeking settlement for over $10,000 for their injuries. The claimant alleged that they frequently exercised and that after the accident, they could no longer attend the gym or run. Our policyholder claimed that the vehicles made no contact, which was substantiated by photos showing no damages. The judge found our policyholder to be liable, stating that our policyholder likely did hit the other vehicle. However, she ruled that the contact was so light that it did not cause any damages or substantial injuries to the claimant. The Court concluded that Maryland Auto owed no money to the claimant.
This is one of many recent examples of the impact of Maryland Auto’s continued diligence in avoiding paying out claims that are potentially fraudulent. According to The Coalition Against Insurance Fraud, “Insurance fraud is one of America’s largest crimes — at least $80 billion is stolen each year.” Insurance fraud not only creates additional costs for insurance carriers but also causes premiums to go up, too. The Coalition estimates that the average household pays around $1,000 extra in insurance premiums each year to make up for the cost of insurance fraud.
“There is a lot of organized fraud out there and it costs us all a lot of money. We at Maryland Auto are committed to identifying and catching fraud. I applaud the efforts of our insurance professionals to prevent fraudulent claims from driving up costs for our policyholders,” said Executive Director Al Redmer, Jr.
Additional examples of Maryland Auto’s efforts to combat claims fraud are available on our blog.
- Insurance Fraud: Everyone Pays for Crime
- Case Study: The Case of the Disappearing SUV
- Case Study: Think Before You Speak