Shareholder Tiffani Palmer recently delivered a dynamic session on a costly and complex issue: insurance fraud, to the National Association of Subrogation Professionals (NASP). With an estimated $308.6 billion in losses annually and up to 20% of claims involving fraudulent activity, the impact on insurers—and consumers—is staggering.
Tiffani’s session, titled—Is That a Bear or a Guy in a Bear Suit? —explored the many faces of fraud, from staged auto accidents and phantom injuries to premium misrepresentation and falsified theft claims. One of the most notorious tactics? The “swoop and squat”—a staged collision scheme that continues to plague the industry.
Key red flags include:
- Inconsistent claim documentation
- High-value claims made shortly after policy initiation
- Claimants reluctant to cooperate
- Disproportionate damage compared to the incident
To counter these tactics, Tiffani emphasized practical investigation strategies:
- Analyzing claim files and medical reports
- Conducting surveillance
- Leveraging AI and social media reviews
- Interviewing witnesses
She also highlighted tools insurers can use to recover losses and reduce fraud frequency, including advanced monitoring systems, collaboration with law enforcement and fraud bureaus, and working with experienced insurance recovery attorneys.
The takeaway? Fraud may wear many disguises, but with vigilance, strategy, and the right partnerships, the industry can continue to spot the guy in the bear suit—and stop him in his tracks.
If you have any questions about Weltman’s consumer collections and subrogation solutions, please connect with Tiffani at any time.
These blogs are not a solicitation for business and are not intended to constitute legal advice on specific matters, create an attorney-client relationship, or be legally binding in any way.
