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Keith Sanders Insurance Group Blog

How Companies Spot Fraudulent Business Insurance Claims

8/8/2019

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Insurance helps businesses get back on their feet after unforeseen damages have struck them, although there are times when fraudulent claims are made. This is why most agents and brokers usually approach all business insurance claims with extreme caution and watchful eyes.
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Insurance companies thoroughly investigate each claim whether it is considered to be a legitimate loss or not. Here are some of the ways that companies use to determine whether a claim is authentic or not:
Are the Customers Padding the Claim and Overstating Revenues?
A survey conducted in 2013 showed that a quarter of the respondents believe that it is acceptable to pay a claim to make up for the deductible. While overstating your expenses is a way to increase the payout you will receive, it is still considered fraud.

An overpayment can be the result of revenue falsification, legitimate revenue exaggeration, and blaming reduced revenue in non-event factors.

Are the Customers Aggressive in Rushing the Process? 
There are also some warning signs that companies watch out for which include the over-aggressiveness of the customer about settling the claim quickly. This allows them to pressure the company with their investigation which might lead to some critical details being overlooked.

Did the Customer Ask Suspicious Questions Before the Incident?
Another is when the customer has asked the broker hypothetical questions that are vaguely similar to the situation at hand. The customer may have already asked these questions already to look for possible loopholes which will allow them to claim the insurance money without much discussion.

Are there Irregularities and Discrepancies with Their Documents?
The company will also check the customer’s financial records to see if there are any questionable information like out-of-sequence receipts and checks. If the customer fails to provide substantive evidence to the agent that will support their claim, then the incident is most likely fraudulent. The agent also checks for records or possible financial loss and small revenue generation.

Although most insurance companies are cautious when it comes to investigating insurance claims, they have a good reason to be because staged insurance claims are quite rampant now. Getting a good business insurance plan is not enough because you will have to be knowledgeable about the terms too, it is going to protect your valuable business after all. 

At Keith Sanders Insurance Group, we do our best in making sure that our clients are well-protected with affordable and comprehensive policies. We make sure to go the extra mile to help you with your needs. To learn more about how we can help you, please contact our agency at (254) 235-8185 or Click Here to request a free quote.
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