INDICATORS OF CASUALTY FRAUD
Extensive injuries reported, but no police called to the scene of the accident
Claimant or Insured excessively eager to accept blame for accident
Claimant or Insured overly pushy or demanding quick reduced settlement
Claimant or Insured unusually knowledgeable of insurance terminology
Claimant or Insured unusually knowledgeable of medical terminology
Multiple unrelated passengers in the vehicle with same medical providers
Multiple unrelated passengers in the vehicle with the same attorney
Claimant threatens to seek medical attention if claim not settled quickly
Claimant threatens to seek legal council if claim not settled quickly
Claimant travels long distances for medical care that is available nearby
Claimant or Insured unwilling to provide a statement related to the facts of loss
Claimant or Insured unwilling to provide a statement about injuries/treatment
Extensive physical vehicle damage minor, subjectively diagnosed injuries present
Loss facts presented to insurer conflict with facts in the initial medical report
Extensive injuries reported, but no police called to the scene of the accident
Claimant or Insured excessively eager to accept blame for accident
Claimant or Insured overly pushy or demanding quick reduced settlement
Claimant or Insured unusually knowledgeable of insurance terminology
Claimant or Insured unusually knowledgeable of medical terminology
Multiple unrelated passengers in the vehicle with same medical providers
Multiple unrelated passengers in the vehicle with the same attorney
Claimant threatens to seek medical attention if claim not settled quickly
Claimant threatens to seek legal council if claim not settled quickly
Claimant travels long distances for medical care that is available nearby
Claimant or Insured unwilling to provide a statement related to the facts of loss
Claimant or Insured unwilling to provide a statement about injuries/treatment
Extensive physical vehicle damage minor, subjectively diagnosed injuries present
Loss facts presented to insurer conflict with facts in the initial medical report
- INDICATORS OF WAGE LOSS FRAUD
Claimant does not know the address of the employer
Wage loss documents presented as proof of loss came directly from claimant
Wage loss documents presented as proof of loss contain spelling and math errors
Wage loss documents presented as proof of loss contain white-outs or erasures
Wage loss documents presented as proof of loss are NOT on company letterhead
Wage loss documents contain illegible signatures and phone numbers
Portions of medical disability release appears altered
| Sullivan Investigation Service, Inc. |
| Since 2004 |
Casualty
| Medical Fraud is a billion dollar business that effects everyone |
NOTE: The fraud indicators identified on this website are examples of issues that may exist in a
claim file. The lists provided are not exhaustive. The existence of any one or any combination of
indicators is not necessarily evidence of fraud. A complete and thorough investigation is needed to
review all the information presented by the parties involved to ensure that it is factual and accurate.
claim file. The lists provided are not exhaustive. The existence of any one or any combination of
indicators is not necessarily evidence of fraud. A complete and thorough investigation is needed to
review all the information presented by the parties involved to ensure that it is factual and accurate.
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