Curb Drive Down Fraud
This video illustrates the popular "Curb Drive Down" staged car accident. Staged traffic accidents are on the rise, endangering the lives and boosting the car insurance rates of innocent drivers who may unwittingly think they're at fault.
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Monday, March 2, 2015
Sunday, March 1, 2015
Insurance News - Thursday, March 1, 2012
$279 Million No-Fault Auto Insurance Scam In NYC Called Largest Ever
A cadre of corrupt doctors and scam artists sought to cheat auto insurance companies out of $279 million in bogus medical claims — the largest-ever fraud involving New York’s no-fault law, authorities said Wednesday.
A $250 Million Fraud Scheme Finds a Path to Brighton Beach
The plot involved 10 doctors, 9 separate clinics in New York City and 105 different corporations, all in service of a health care fraud ring that federal authorities say conspired to steal more than a quarter of a billion dollars from insurance companies. And when the details were announced on Wednesday, they cast an unflattering spotlight on how immigrants from the former Soviet Union have often dominated such schemes in the city.
read more...
A cadre of corrupt doctors and scam artists sought to cheat auto insurance companies out of $279 million in bogus medical claims — the largest-ever fraud involving New York’s no-fault law, authorities said Wednesday.
The investigation resulted in federal racketeering, health care fraud, mail fraud and money laundering charges against 36 people, mainly of Russian descent. They include 10 physicians and three lawyers. One had the nickname “KGB.”
At a news conference, U.S. Attorney Preet Bharara said while the false claims totaled $279 million, the actual loss to private insurers was $113 million. Some of the ill-gotten gains were spent on vacations in Mexico, shopping sprees at Saks Fifth Avenue and rides in limousines, he said.
read more...A $250 Million Fraud Scheme Finds a Path to Brighton Beach
The plot involved 10 doctors, 9 separate clinics in New York City and 105 different corporations, all in service of a health care fraud ring that federal authorities say conspired to steal more than a quarter of a billion dollars from insurance companies. And when the details were announced on Wednesday, they cast an unflattering spotlight on how immigrants from the former Soviet Union have often dominated such schemes in the city.
This one, like many others, was rooted in Brighton Beach, Brooklyn, the locus of the city’s Russian-speaking immigrant population, many of whom grew up under a Communist system that bred disdain for the rules and a willingness to cheat to get around them.
Brighton Beach has one of the highest rates of health care fraud in the nation, according to federal statistics. In fact, an analysis of data from the Centers for Medicare and Medicaid Services, the federal agency that regulates those two programs, shows that more health care providers in the Brighton Beach ZIP code are currently barred from the programs for malfeasance than in almost any other ZIP code in the United States. (The top spot is in southern Florida, with its high proportion of older residents.)read more...
Insurance News - Friday, March 1, 2013
Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Friday, March 1, 2013:
- IBC met with the NDP today to discuss auto insurance premiums and initiatives that can reduce rates including implementing anti-fraud measures, implementing reforms to FSCO DR system and revising the catastrophic impairment definition.
- Andrea Horwath says she had a productive meeting with industry leaders but warns of election if auto insurance premiums aren’t cut.
- Auto insurance battle under way in the North Carolina legislature as insurers look to opt out of rate making process administered by their Rate Bureau.
- Check out Shepstone v. Cook, an Ontario Superior Court decision dealing with the verbal threshold. The Court ruled that shoulder & low back pain was not a permanent serious impairment.
Landslides and mud-slides: NOT covered by a standard homeowners policy
The New York Times has an interesting story today about a significant hazard here in the rainy Pacific Northwest: mudslides.
Mudslides and landslides, the article notes, are "a topographical drama less spectacular but far more common than the potentially deadly earthquakes, avalanches and tsunamis that loom in anxious minds across the Pacific Northwest."
And here's what many homeowners don't know: mudslides and landslides aren't covered by a standard homeowners policy. So it can be very difficult to collect for losses caused by any form of land movement unless you bought specific additional riders or policies, like these:
Landslide coverage: You may be able to buy a special rider for your homeowners policy that includes coverage for contents for all perils, including earth movement. But this type of rider only covers contents, not the structure, and some insurers don't offer this option at all. For the structure, you may be able to buy separate earth-movement coverage from what's known as the "surplus lines" market, meaning insurers who specialize in risks that the traditional insurance industry doesn't cover. But if your home is on a hillside, it may be difficult to get this kind of coverage.
Flood insurance: Flood insurance may apply to some kinds of earth movement, such as water-related erosion, mudflows or flash floods. Most homeowners seeking flood coverage start with the National Flood Insurance Program, which is federally run but sold by local agents and brokers.
Earthquakes: Quake damage is another category of risk not covered in a standard homeowners policy, but you can buy this coverage to protect against losses from an earthquake -- or quake-triggered landslides.
Mudslides and landslides, the article notes, are "a topographical drama less spectacular but far more common than the potentially deadly earthquakes, avalanches and tsunamis that loom in anxious minds across the Pacific Northwest."
And here's what many homeowners don't know: mudslides and landslides aren't covered by a standard homeowners policy. So it can be very difficult to collect for losses caused by any form of land movement unless you bought specific additional riders or policies, like these:
Landslide coverage: You may be able to buy a special rider for your homeowners policy that includes coverage for contents for all perils, including earth movement. But this type of rider only covers contents, not the structure, and some insurers don't offer this option at all. For the structure, you may be able to buy separate earth-movement coverage from what's known as the "surplus lines" market, meaning insurers who specialize in risks that the traditional insurance industry doesn't cover. But if your home is on a hillside, it may be difficult to get this kind of coverage.
Flood insurance: Flood insurance may apply to some kinds of earth movement, such as water-related erosion, mudflows or flash floods. Most homeowners seeking flood coverage start with the National Flood Insurance Program, which is federally run but sold by local agents and brokers.
Earthquakes: Quake damage is another category of risk not covered in a standard homeowners policy, but you can buy this coverage to protect against losses from an earthquake -- or quake-triggered landslides.
Insurance News - Saturday, March 1, 2014
Here are the leading auto insurance headlines from ONTARIO AUTO INSURANCE TOPICS ON TWITTER for Saturday, March 1, 2014:
- Who owns all that data your car generates?
- New York "creates" highway texting zones at existing rest stops and service areas but will that stop drivers from texting? After all, drivers who need to use their phone should already be stopping at these locations.
- Now a California court has ruled that hand-held cell phone law are only meant to apply to drivers making a call. So it's fine to hold phone to use map.
- It's not just insurers who will be hurt by the introduction of self-driving cars. Everyone who makes money off of car accidents is going to feel it.
- Insurers are denying claims and cancelling policies of vehicle owners that are using their vehicles as part of a ridesharing service.
What you can do when your health insurer says no
Little-known fact: When your health insurer denies a treatment or won’t cover a bill, that’s not necessarily the final answer. In most cases, you can appeal that decision.
Even if the insurer says no, consumers can often appeal to an independent group with the power to overrule the company. Nearly a quarter of Washingtonians who do that end up winning.
Our office has posted an easy-to-use guide to filing appeals on its website at www.insurance.wa.gov/your-insurance/health-insurance/appeal. Since we're the insurance regulator for Washington state, it's designed for Washington residents, but many of the tips apply more broadly.
The guide has been recently overhauled to make it easier to use. It includes step-by-step tips, examples, and downloadable letters that consumers can fill out and send to their insurer.
We also experts on staff who can help Washington state consumers with their appeal. They can be reached at 1-800-562-6900 or AskMike@oic.wa.gov.
And if you don't live in Washington state, here's a handy map showing how to contact your state's insurance regulator.
Even if the insurer says no, consumers can often appeal to an independent group with the power to overrule the company. Nearly a quarter of Washingtonians who do that end up winning.
Our office has posted an easy-to-use guide to filing appeals on its website at www.insurance.wa.gov/your-insurance/health-insurance/appeal. Since we're the insurance regulator for Washington state, it's designed for Washington residents, but many of the tips apply more broadly.
The guide has been recently overhauled to make it easier to use. It includes step-by-step tips, examples, and downloadable letters that consumers can fill out and send to their insurer.
We also experts on staff who can help Washington state consumers with their appeal. They can be reached at 1-800-562-6900 or AskMike@oic.wa.gov.
And if you don't live in Washington state, here's a handy map showing how to contact your state's insurance regulator.
Large health insurer surpluses could help ease premiums
The News Tribune of Tacoma and the Bellingham Herald this morning ran an op-ed column by Commissioner Kreidler, talking about the fact that -- under current law -- our rate reviews of health premiums have to ignore the billion-dollar surpluses that some non-profit health insurers are sitting on.
From the op-ed:
From the op-ed:
Two of this state’s largest insurers – Premera Blue Cross and Regence BlueShield – are sitting on surpluses totaling $2.2 billion. In fact, their surpluses grew almost a quarter-billion dollars in the first nine months of 2012 alone.We're seeking legislation -- House Bill 1349 -- that would allow us to take surplus into account when the rates are reviewed.
As the state’s insurance regulator, I review insurance premiums. If they’re unjustifiably high, I tell companies they cannot charge that much. This is a critical protection for Washington consumers.
But here’s the elephant in the room: Under current law, I am barred from taking those surpluses into account when I review rates. This is despite the fact that regulators in nearly a dozen other states, including Oregon, have the authority to do so.
By factoring surpluses into rate reviews, I can help protect consumers from sticker shock in their health care premiums, while still ensuring that carriers are financially healthy. It would be a tragedy – both for the economy and for individuals – if lawmakers chose to put the interests of insurance companies ahead of their constituents.