Restoration Insurance: Prevent Fraud

November 12, 2019


Insurance fraud is increasing for restoration contractors.  The most frequent cases involve worker’s compensation claims and health insurance. As the amount of fraud increases, so do the tactics used by insurance investigators to catch the perpetrators.


Fraudulent can and will adversely affect your insurance premiums so it’s important that you for the following red flags that may indicate fraud or at least the need to investigate a claim more closely:

  • Look at the claimant’s claims history – Has he or she filed similar claims recently or repeatedly? Are there any recurring or unusual patterns involved?

  • Look for “Suspicious Loss Indicators” – The National Insurance Crime Bureau has a list of suspicious loss indicators that can tip off an adjuster or agent such as hand-written receipts or a claimant who’s too calm after filing a claim.

  • Look at the claimant’s credit history – Is he or she in debt? Does the person live above his or her means? Are there major medical bills or recent unemployment?

  • Check out the claimants on social media – If there are pictures of him surfing, his back may not be that badly injured. Did what she said about the car accident on Twitter match her description of the accident? Or did someone upload a video to YouTube that shows what really happened?

If you have noticed any of the above warning signs with claims at your restoration company, please contact our office for suggestions and ideas on how properly investigate potential fraud and how to prevent it in the future.


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