Something to think about before commiting fraud.

Posted: Mon Dec 24, 2007 11:47 am Post Subject:

While I agree with you Quenlin to a degree...Unfortunately it has been my professional experience that these types tend to run in a family.... :(

Posted: Tue Dec 25, 2007 04:19 am Post Subject:

Hey Lori, Merry Christmas Eve
Here's something along those very lines, but with a twist.

I've been investigating the Americo Investment and Life Insurance Company for a few months now and have actually found a father-daughter team of agents who have violated the state insurance code as well as IRS regulations in at least a dozen different cases.

Being an agent for quite some time, the father obviously took it upon himself to train his daughter in this way. My question is therefore; What's worse? The family who learns to defraud an insurance company or the family who learns how to misrepresent the terms and conditions of policies?

Although the first bunch could contribute to an increase in premiums, the latter could potentially harm a larger number of policy holders to a much greater degree.

Posted: Tue Dec 25, 2007 05:56 am Post Subject: no bounds..

A Merry Christmas to all of you!

Whenever you burned your house down, left your car on a railway crossing, or pretended to be suffering from the latest disease.

Posted: Tue Dec 25, 2007 06:50 am Post Subject:

Gosh!!! Scams seem to be running in the vein of the insurance business. Policy holders, agents, insurers all are scamming others. IMO, it's more important to understand its impact on the global insurance scenario than considering the isolated cases.

Insurance frauds can no longer be considered as the small and petty crime. Scammers now operate in the most advanced and organized form, involving entities like-health care units, lawyer's office, business giants, body shop owners and so forth. The incidents ain't rare where a doctor is ready to write a false certificate for the bodily injuries…..mechanics ready to inflate the repair bills in order to skim more money from the insurer.

It seems that dishonesty have engulfed the whole society. And the law enforcement authority's inability to unearth most of these events is allowing the fraudsters to go scot-free with their booty.

MERRY CHRISTMAS ALL!!! :D

Posted: Tue Dec 25, 2007 09:57 am Post Subject:

My question is therefore; What's worse? The family who learns to defraud an insurance company or the family who learns how to misrepresent the terms and conditions of policies?

Posted: Wed Dec 26, 2007 05:52 pm Post Subject:

It really irritates me to see someone pretending to be sick, I just watched a friend who went through 5 years of chemotherapy and passed away this summer, she would have given anything for one more day, even as sick as she was.
The SSI seems to be a family tradition in my parts, usually they will all live in the same household and start collecting for the child at a very young age, one guy around here refers to it as his pension. If I had to live on that pension I would be broke, no ambition and they pass that mind set on to their children. sad but true.

Posted: Thu Dec 27, 2007 09:22 am Post Subject:

I agree dreamer as I said, unfortunately these ''types'' seem to learn at the knee of mama and daddy....

Posted: Sat Dec 29, 2007 07:50 pm Post Subject:

Not that it is right, but, most of you know, most of the insureds don't know they are committing fraud when they ask the shop to save their deductible, or repair a damage that was not part of the accident. Many just feel it is owed to them because all the years of paying for their policies. It is further beyond their perception of “fraud” because they may only have one or two accidents their whole lives, and really not know any better.

Posted: Sat Dec 29, 2007 11:29 pm Post Subject:

I agree Jake, some are 'innocently' commiting fraud or although they know deep inside it's fraud there is a sense of 'entitlement' (which makes me crazy) you also know there are those customers that will shop a shop till they find one that will do the wrong thing, and unfortunately (for you and other shops with character) there are too many shops willing to commit fraud and THEY know better....

Posted: Tue Jan 01, 2008 11:14 am Post Subject:

It seems as if there are people out there ready and willing to commit fraud on any basis, car, health, home and compensation. I know a lady who is a retired school teacher, she said that her student's parents were sending in the social security insurance forms for her to evaluate and sign. She said that after a while that she stopped doing it, that these parents were not using this money towards these children and that alot of these kids were very capable of learning, just chose not to at a very young age and continued the cycle through out life. Once they were old enough, they would apply for the adult SSI, this is one of the most abused benefits ever, here in Pennsylvania, when they started cracking down on the welfare system, it seems everybody ran to the social security office. What puzzles me is that you don't just walk in and say you want it and get it. You have to have alot of proof that you are disabled, now either there are alot of smart people knowing how to fraud the system or the other areas and professions that are in the world of "people care" have caught on to the game too.

Our community guidance center will help an individual file for social security benefits, now if you think about it, if the person is a good actor, or just has a family tradition of these behaviors and they go in there, well the same doctor is treating mom, dad, uncle bob, aunt sue and whoever else may be collecting a check, you are naturally next in line. You will eventually get your benefits, you will naturally have the health care needed to pay my office and what do you know, job security to me. I believe there are some legit cases, but I think if they would seriously evaluate these individuals as they do someone who has worked for 20-30 years and then has an accident or a health issue that forces them to be off work they would find the caseload going down. The social security administration, at least here, puts working people through the ringer when they need to file a claim and the majority of them are legit physical claims, where most of the ssi claims are mental. The mental health industry is making a killing off this, I bet if they started cracking down on this, the caseload would lighten up in a heartbeat.

It just sickens me when a couple will come in to our office, forced to come there by some agency, first words out of their mouths is they are disabled, We see some legit cases and we have some state agencies that take their jobs seriously and work to get these individuals work or training to go to work. Most truly disabled people want to work and don't want to be in that situation and will let you know that from the beginning.