NICB: California Posts 28 Percent Increase in Questionable Claims 2010-2012

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Dec 11, 2013, 08:00 ET

Los Angeles Metro Area Leads State

DES PLAINES, Ill., Dec. 11, 2013 /PRNewswire-USNewswire/ -- The National Insurance Crime Bureau (NICB) today released its 2010-2012 California questionable claims referral reason analysis. Questionable claims (QC) are those claims that NICB member insurance companies refer to NICB for closer review and investigation based on one or more indicators of possible fraud. A single claim may contain up to seven referral reasons. This report analyzes QCs by loss city, core-based statistical area (CBSA), policy type, loss type, policy and loss type combined and referral reasons.

In 2010, there were 17,092 California QCs referred to NICB from its member insurance companies. In 2011, the number rose to 19,388 and in 2012, it increased to 21,935—an increase of 28 percent from 2010's figure.

The top five cities in California generating the most QCs last year were Los Angeles (3,246), San Diego (862), San Francisco (599), Sacramento (594), and Oakland (494). The top five CBSAs reporting QCs were Los Angeles-Long Beach-Santa Ana, San Francisco-Oakland-Fremont, Riverside-San Bernardino-Ontario, San Diego-Carlsbad-San Marcos and Sacramento-Arden Arcade-Roseville. The top five loss types were: bodily injury, theft, collision, vandalism and malicious mischief and property damage.

It is important to note that QCs represent a fraction of overall claims traffic. Nationally in 2012, QCs totaled 116,268 out of an overall claims population of more than 70.5 million—or 0.164 percent. The volume of QC referrals can increase or decrease over a given period of time and may be caused by a number of factors, including better reporting by the industry and an increase or decrease in fraudulent activity, etc.

The full report is available here.

Anyone with information concerning insurance fraud or vehicle theft can report it anonymously by calling toll-free 800-TEL-NICB (800-835-6422), texting keyword "fraud" to TIP411 (847411) or submitting a form on our website. Or, download the NICB Fraud Tips app on your iPhone or Android device.

About the National Insurance Crime Bureau: headquartered in Des Plaines, Ill., the NICB is the nation's leading not-for-profit organization exclusively dedicated to preventing, detecting and defeating insurance fraud and vehicle theft through data analytics, investigations, training, legislative advocacy and public awareness. The NICB is supported by more than 1,100 property and casualty insurance companies and self-insured organizations. NICB member companies wrote $350 billion in insurance premiums in 2012, or more than 78 percent of the nation's property/casualty insurance. That includes more than 93 percent ($160 billion) of the nation's personal auto insurance. To learn more visit www.nicb.org.

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SOURCE National Insurance Crime Bureau