Insurance Investigations
The National Insurance Crime Bureau (NICB) reports that after tax evasion, fraud is the most costly white-collar crime in the United States. It's not only costly to insurance companies and businesses, but a portion of the costs are passed along to consumers. NICB estimates that at least 10 percent of all property and casualty insurance claims are filed incorrectly with intent to defraud. Who commits insurance fraud?
Unscrupulous repair shops, contractors, and individuals
Dishonest attorneys, physicians, chiropractors, dentists, and other professionals
Organized rings dedicated to sophisticated, large-scale fraud
Individuals who add to or pad their claims
National Insurance Fraud Investigators (
Insurance Overview
Insurance is a contract between the insured, who agrees to pay for services, and the insurer, who agrees to provide monetary reimbursement for certain losses that may be incurred by the insured. There are two very wide categories of insurance: government insurance and private insurance, each divided into industries. Government insurance can be divided into compulsory and voluntary, while private insurance is usually divided into four sectors: casualty, fire, life, and marine.
Government Compulsory Insurance can be:
Unemployment benefits
Social Security benefits
Workers' compensation in many states
Government Voluntary Insurance examples:
Savings and loans and bank depositor insurance
Federal crop insurance
Military personnel insurance
Flood insurance
Private insurance is voluntary, except for the compulsory (basic collision) automobile insurance required on all drivers in most states. There are many types of private insurance, but some of the basic types are listed below.
Basic Types of Private Insurance
Life
Home
Rental
Automobile
Health and medical
Specialty insurance
It's important to be familiar with appropriate terms in order to work in the insurance industry. Knowing something of the most used terms will also help you when interviewing for a position investigating insurance fraud. Several Web sites offer glossaries of terms related to the industry. Some are:
AM Best:
Glossarist:
Insurance Information Institute:
Hanover Insurance Group:
Trafalgar International LTD:

