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Claims
Servicing >
by: Walter J. McIntosh
Retired Special Investigation
Unit Manager
Insurance fraud is the second most popular white collar crime in
both Hawaii and in the nation overall. It ranks right behind tax
fraud. And people tend to look the other way at this crime in spite
of the fact that it costs each and every one of us hard-earned money.
How much are we talking about? Here in Hawaii, about $200 of the
average yearly cost of auto insurance goes to pay for the fraud
that others are committing.
What is fraud?
Insurance fraud is legally defined as intentional deception with
the purpose of unwarranted financial gain from an insurance company.
Under the new Hawaii Motor Vehicle Law, if anyone presents a fraudulent
claim they have committed the crime of insurance fraud.
What are some examples of insurance fraud?
- Reporting accidents that did not really happen, trying to gain
monetary compensation for an accident that did not take place.
- Claims for injuries a person really did not sustain.
- Falsely reporting stolen cars or vandalizing to fraudulently
collect on insurance - often these vehicles are burnt to destroy
evidence.
- Overinflating a claim to cover the policy deductible or the cost
of insurance premiums.
- Staged accidents known in criminal circles as "swoop and squat"
operations, where preplanned maneuvers are used to set up an innocent
party for a rear end collision. One vivid example is a car that
swerves around another car then stops immediately, causing the
unsuspecting driver to hit it. Sometimes the person(s) who caused
the "accident" will ask the other driver to pay for the damages
and not report the accident. Other times, they will claim damages
from the other driver's insurance company.
What can be done to stop insurance fraud?
- Report any incident of suspected fraud to your local police department.
- Inform the insurance company of the victimized driver of your
suspicion of fraud.
- For AIG Hawaii, report suspected fraud to the Special Investigation
Unit (SIU) - at 543-0449.
- Report any suspicious incident to the State Insurance Division's
Fraud Investigation Unit.
How does fraud affect my policy?
The fact that insurance fraud is now a felony (e.g., any fraudulent
claim of over $300 is deemed to be a Class C felony) must be noted
on every policy. This is a warning that there are criminal penalties
attached to committing fraud. Insurance fraud is an offense giving
rise to forfeiture and other serious penalties.
Working together to reduce fraud can bring down the cost of insurance
for all of us.
Walter J. McIntosh is the Special Investigation Unit Manager for
AIG Hawaii Insurance Company, Inc. He was formerly an Operations Officer
with the U.S. Central Intelligence Agency (CIA) and has the designation
of Certified Fraud Examiner (CFE) and Certified Insurance Fraud Investigator
(CIFI).
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