May 27, 2018

Risky Business

Risky Business
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Wrong Side of the Law

A lawyer has been sentenced in a motor insurance fraud. He allegedly was part of a group of clinic owners, chiropractors and attorneys involved in the scheme that involved care at chiropractors’ clinics. He pleaded guilty and was sentenced to more than a year in prison and millions to be...

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In or Out?

A doctor was billed separately for a nose injury sustained by her son in the hospital that she worked. She was asked to pay for the services of the emergency doctor who was not within the provider network of the hospital. She took up the case with her insurer who...

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Nat Cat Folly

A woman bought herself earthquake insurance that would cover her structure and stay in the event of rebuilding. Shortly after she received a notice from the insurer saying that the policy would be cancelled for non-payment of funds. She produced proof of payment and was notified that it was a...

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Burden of Proof

A man has been found to have provided false statements while demanding for a reimbursement for a ‘foot injury’. He claimed that a letter from a signboard blew off a restaurant wall and hit his foot during a hurricane. However he was arrested later after he was seen on video...

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Phony Pharma Care

Four pharmacists have been charged with fraud along with a doctor and a patient recruiter for planning and carrying out an elaborate fraudulent scam over a period of six years netting the culprits USD5 million. The group billed leading medical insurers for controlled and highly priced medicines. The scam was...

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Busted without commissions

A quartet of former life insurance agents was arrested for the role in a major scam. They submitted fraudulent life insurance applications to score advance commissions from insurance companies. An investigation revealed that they submitted more than 600 applications and deposited the commission in multiple bank accounts to avoid suspicion....

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Claim turns criminal charge

A man purchased a vehicle insurance policy from an agent and filed for a claim five days later. He said the accident occurred about an hour after he purchased the insurance policy. The agent then contacted the insurer of the other party involved in the accident and he said the...

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A gruesome fraud

A man was charged and accused of providing evidence to prove the death of his brother in order to claim an insurance amount. The man allegedly took out the insurance policy in his brother’s name after his death and tried to claim for it. The private investigators hired by the...

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Wild Driver

An insured tour boat had quite surprisingly churned out 22 injury claims which cause the insurance company to take a closer look at the data. Most of the claimants had suffered back injuries after taking a pounding in the fast boat. So the adjuster decided to see what was happening...

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Failed Warning

A woman was telling the workers in her organisation that the area she was walking in should have cones placed to alert others lest they should slip and fall. Unfortunately while she was instructing the workers, she slipped and her feet went flying out from under her. The claim was...

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