What is BI fraud?
In the United States, BI, or bodily injury fraud, refers to automobile insurance fraud where someone claims they were injured in an auto accident and seeks compensation from a third party who allegedly caused the accident and allegedly caused “bodily harm”
What is BI?
In the United States, BI stands for coverage for bodily injury caused by someone else during an automobile accident. This is the coverage that people are obligated to buy in most US states to provide compensation to others they may harm via an accident that they cause. This coverage is primary in US states except for states that use PIP coverage, like Delaware, Florida, Hawaii, Kansas, Kentucky, Massachusetts, Michigan, Minnesota, New York, New Jersey, North Dakota, Oregon, Pennsylvania, and Utah. The required limit of coverage (the amount the insurance company will pay the third party) varies from state to state, but many people choose to purchase a coverage higher than the minimum.
Who commits BI fraud?
BI fraud can happen in many ways. For example, it may just occur as the opportunity presents itself. Someone may be legitimately hit in an accident and even legitimately hurt, but they inflate their bodily harm in an effort to receive more money from the insurance company. On the other hand, others may be involved in staging accidents.
How we spot it
We have proprietary algorithms that are constantly sifting through an insurance carriers data. We have calibrated these algorithms to detect patterns in accidents, especially in regards to their treating clinics and/or other vendors, which detect when a series of accidents occur which very likely were not caused by chance. As soon as this becomes apparent, these claims are flagged and immediately given as leads to an SIU department.
Why are we different?
Our focus is to provide leads to SIU, not build a system that “pre-clears” claims. We have seen many algorithmic systems sold with the purpose of fast tracking claims. Whether you fast track a claim is your business; but we will analyze all claims as they go through your system and provide a lead to SIU when potential fraud is spotted. Furthermore, our algorithms are not fooled by people who have managed to stay out of databases related to past criminal activity, such as recent immigrant arrivals.
- California woman pleads guilty to being a part of a staged accident ring
- California: Chiropractor arrested in connection with fraud
- Louisiana: Feds charge 5, including an attorney, in alleged phony accident, insurance billing scheme
- Washington: 8 plead guilty to staging 13 accidents worth $2.8 million
- Nevada: Ex-correctional officer pleads guilty in fake accident case
- Nevada: Five plead guilty as part of a 27 person ring staging 19 accidents
- Texas, 22 indicted for allegedly participating in staged accident scheme worth more than $1 million