Insurance Fraud Investigations

The 7 red flags of fire loss insurance claim. If your answer is yes to any of these red flags, then you may have a case of insurance fraud in your hands:

• Does the claim include expensive property, often newly purchased without documentation, allegedly destroyed along with the home?
• Is sentimental property suspiciously not listed among the missing/destroyed property?
• The claimant cannot provide detailed descriptions of the destroyed property or where it was purchased?
• Does the documentation provided by the claimant look altered or irregular?
• What the claimant claims in property loss does not match the physical site?
• The claimant refuses to answer questions, or gives confused or inconsistent answers?
• The claimant fails to provide additional documentation when asked, even if he promises to do so?

The 4 red flags of hospital billing insurance claims. If your answer is yes to any of these red flags, then you may have a case of insurance fraud on your hands:

• Do the bills appear irregular, or documentation is incomplete?
• There is a history of claims by the subject for different, seemingly unrelated health procedures or
  treatments?
• Dates and locations for hospital visits seem unlikely or cannot be corroborated with verified records?
• The claimant avoids answering questions about the claim or gives confusing or inconsistent answers?