Posts Tagged ‘claims fraud’

Louisiana: “…an unknown third vehicle waves down an 18-wheeler”

Attorneys for Mississippi-based Whitestone Transportation “allege in court documents that their investigations have uncovered evidence of more than 30” incidents around New Orleans following a distinct pattern of “multiple people in a claimant vehicle, sideswipe allegations with commercial vehicle trailers, minimal damage to claimant vehicle, little to no damage to the insured trailer and a commercial vehicle driver who is either unaware of or denies impact, according to trucking attorneys.” “In Louisiana we estimate our insurance costs are three to five times more than the national average,” said Chance McNeely, executive director of the Louisiana Motor Transport Association, and with the legal system not well suited to defeating claims for staged or pretended accidents, companies are increasingly turning to truck-mounted cameras.

“It’s always the same thing: Four people in a sedan, and there’s always a random witness who gives a loose statement to the cops and has a random appointment and has to get away, “ McNeely said. And all too often they use the same attorneys and the same doctors, he said….

“We have a lot of billboards for attorneys, and many of them demonize our industry,” he said.

[Eric Miller, Transport Topics]

Great case, if only she’d been in the smashed-up car

“The defense said the case, which involved substantial medical damages and a plaintiff who miscarried after the collision, would have been a great plaintiff’s case — if she had actually been in the car she claimed was wrecked.” Instead, after “defense testimony showed that she swapped out the scarcely damaged car before police arrived with another that had been wrecked years earlier” she “walked out of a DeKalb County courtroom with nothing.” [Atlanta; Greg Land, Daily Report Online]

Dan Lewis on the unlucky past of Vernon, Florida

A small town in the Florida Panhandle has long tried to live down its special place in the history of insurance fraud. “By the time the early 1960s rolled around, according to the Tampa Bay Times, Vernon, Florida was responsible for roughly two-thirds of all loss-of-limb-related insurance claims in the United States.” I’ve written on the story a number of times, and Dan Lewis of the oft-recommended-here Now I Know website penned this account in 2012 which I seem to have overlooked at the time, an omission I remedy herewith.

Did bots fraudulently submit $400,000 in claims in a class action settlement?

“U.S. District Judge Jon Tigar asked federal prosecutors to investigate nearly 6,000 potentially bogus claims submitted in a $5.3 million settlement with app makers, including Twitter, Instagram and Yelp…. None of the [5,924] identified claims used unique claim numbers provided in email notices that were sent out to potential class members. In addition, numerous claims had different physical addresses but came from identical IP addresses.” [Ross Todd, The Recorder] Some used repetitive street addresses and unlikely or repetitive names of individuals, including at least one individual who was a legitimate member of the class but whose name was used by others to file claims. [Alison Frankel, Reuters (“The class action claim bots are coming! (Actually, they’re already here)”); ABA Journal]

UK tourists abroad file wave of food poisoning claims

“Tens of thousands of UK tourists have put in for compensation [for food poisoning] in the past year, even though sickness levels in resorts have remained stable,” reports the BBC, in what Mark Tanzer, chief executive of trade travel association Abta, says is “one of the biggest issues that has hit the travel industry for many years”. Travel firm Tui “said it had experienced a 15-fold rise in holiday sickness claims in the past year, costing between £3,000 and £5,000 a time.”

Joel Brandon-Bravo, managing director of Travelzoo UK, told BBC Radio 5 live’s Wake Up To Money that the upward trend was being driven by claims management companies.
“People are being called when they get back from holiday and encouraged to make claims and we’ve also seen evidence of them employing touts outside resorts encouraging people to make a claim and walking them through the process to make it easy for them,” he said….

Abta says the cases usually involve holidaymakers who have been abroad on all-inclusive deals, who argue that because they only ate in their hotel, that must have been the source of their alleged food poisoning.

Sometimes it is possible to cast doubt on the claims, per a report by Tanveer Mann at Metro:

Two British tourists who claim they were left ‘bed-ridden’ as a result of food poisoning actually had more than 100 drinks while on an all-inclusive holiday in Gran Canaria, according to their hotel bill….

The CEO of [defendant] Jet2holidays, Steve Heapy, said: ‘The sharp rise in the number of sickness claims is costing hoteliers and travel companies dearly, and it’s frustrating when so many are made a year or more after the holiday has ended.

There is also fear that some overseas resorts will begin barring access to British holidaymakers entirely as unprofitable.

In the BBC report, Abta “says laws designed to stop fraudulent claims for whiplash have instead pushed the problem of false insurance submissions on to overseas holidays instead. This is because of a cap on the legal fees that can be charged by law firms pursuing personal injury cases at home.”

Whiplash and incentives, abroad

“In my first 20 years as a consultant I wrote many reports which were economical with the truth – the truth being that there was very little wrong with the vast majority of compensation claimants that I saw. I was moving with the herd.” While lawyers, insurers, and others are all complicit, writes Dr. Charlie Marks, the onus is on the medical profession to speak up against medico-legal misdiagnosis [Irish Times via Patrick Collinson, The Guardian (“Whiplash: the myth that funds a £20bn gravy train”)]

Medical roundup

  • “Apple Watch can detect an early sign of heart disease…. Apple has been communicating privately with the FDA for years about medical devices and so far the FDA has taken a light touch to Apple but these issues are coming to a head.” [Tyler Cowen]
  • “[Investor] lawsuits targeting life sciences firms jumped 70 percent from 2014, according to a survey provided earlier this year by Dechert.” [Amanda Bronstad, New York Law Journal]
  • Iowa Gov. Terry Branstad signs medical malpractice reforms into law [Brianne Pfannenstiel, Des Moines Register]
  • Summing up what is known re: talc and ovarian cancer as background to jury’s $105 million verdict against Johnson & Johnson [BBC (in story’s second half), earlier here, here, and here]
  • $5,300 for an MRI that would cost Medicaid $500? Personal attendants for crash victims, even the ones well enough to participate in mixed martial arts? All part of Michigan no-fault crash system [Detroit Free Press investigative series, see yesterday’s post]
  • Dear D.C.: ditch the FDA deeming regs and let vaping save smokers’ lives [Jeff Stier/Henry Miller, NRO, Tony Abboud/The Hill (vaping trade association), Juliet Eilperin/Washington Post (FDA temporarily suspends enforcement)]

Detroit Free Press investigates crash-claim abuse

“Detroit drivers face the highest average auto insurance rates in the country, often more than $3,000 a year for a single vehicle,” while residents of Michigan as a whole pay the third highest rates of any state. A Detroit Free Press investigation by J.C. Reindl and others “finds that runaway medical bills, disability benefits payouts and lawsuits under Michigan’s one-of-a-kind, no-fault insurance system play a key role in driving up costs.” One key difference: of the twelve states that mandate no-fault insurance, only Michigan provides for unlimited lifetime benefits.

Some findings from the series:

* “Ambulance chasing” and solicitation thrive notwithstanding laws intended to curb those practices. Despite privacy rules governing police reports and hospital admissions, for example, those involved in crashes are often solicited within hours, then signed up with law firms that later disavow any knowledge of solicitation. And how did an accident treatment clinic in suburban Detroit come to be owned by a California and Florida plastic surgeon noted for appearing on “The Real Housewives of Orange County” who seldom visited?

* While crashes in Wayne County (Detroit) declined from 72,227 to 50,548 between 2003 and 2015, “first-party” lawsuits — against one’s own insurance company for no-fault benefits — increased from 1,699 to 6,327 and negligence suits against other drivers from 2,527 to 3,435. Many “first-party” claims, of course, are paid without anyone filing suit, which is how no-fault law contemplated would be normal practice;

* Auto insurers have launched racketeering lawsuits aimed at proving forms of collusive fraud. Unlike many states, Michigan has no official watchdog charged primarily with combating auto claims fraud.

* “Defenders of the current system include the powerful Coalition Protecting Auto No-Fault, made up of trial lawyers, medical clinics, disability advocates and, until recently, the state’s hospital lobby.”

* Other states’ approaches to containing no-fault costs.