Hi,
The web page below gives details about CALIFORNIA WORKDERS' COMPENSATION CLAIMS:
Regards
epedia.
-----------------------------------------------------------------------
http://neuro-mancer.mgh.harvard.edu/ubb/Forum106/HTML/004596.html
"According to various industry surveys, each year the costs of fraud are
estimated to be in the billions of dollars with four out of every 10 claims
having some elements of fraud. Recent legislation requires that carriers
adhere to certain criteria that address the problem of fraud in the claims
process. Severe fines and/or penalties have been levied against companies
that have not complied in the fight against fraud. Most states require
insurance companies to file a fraud plan, establish and maintain a special
investigation unit, and train the claims and underwriting personnel."
But what does the data from California from 1994 to 1999 indicate?
Referred as suspect
Year------#-Claims (3)----# referrals--% referred
1994(1)--604,432.------3,914-------0.65%
1995-----596,384-------4,416-------0.74%
1996-----602,009-------3,779-------0.63%
1997-----647,091-------3,546-------0.55%
1998-----638,076-------2,765-------0.43%
1999(2)--283,975-------1,772-------0.62%
Total---3,371,967------20,192-------0.60%
That is 6/10's of 1% of all claims filed resulted in a referral for further
investigation even though insurers are required by law in California to
report suspected fraud.
--------------------------------------------------------------- |