Mercury’s Special Investigation Unit exposed more than $24 million of attempted insurance fraud in California during 2013
LOS ANGELES, Calif. (June 11, 2014) – Insurance fraud, the second most costly white collar crime in America (behind tax evasion) continues to grow, with questionable claims rising 26.7 percent across the U.S. in the two-year period from 2010-2012. The Mercury Insurance Special Investigation Unit (SIU), otherwise known as the CSI of the insurance industry, consists of 50 investigators nationwide who inspect questionable claims from people looking to lie, cheat and steal their way into a few extra bucks.
As an example, Mercury’s SIU team completed 1,476 investigations in California during 2013, exposing more than $24 million in attempted fraud.
“It’s amazing the things people will do to try and cheat the system, but they don’t know we’ve seen it all,” said Dan Bales, national director of special investigations for Mercury, which established one of the country’s first SIU’s back in 1978. “Our SIU goal is to stay several steps ahead of these criminals and continue to uncover fraud, which can contribute as much as 30% of customers’ premiums. So we know our efforts have a direct impact on what our customers pay, and they help keep Mercury’s rates among the lowest in the industry.”
Below are Mercury’s 2013 “Best of the Worst Claims,” which highlight some of the inartistic methods people enlisted to beat the system … but lost.
Claim #3: Smack That
The claimant alleged he was struck as his bicycle passed behind the Mercury-insured vehicle that was backing up in a parking lot. He called the police, filed a report claiming injury and property damage, and was then transported by ambulance to a medical center to treat his alleged injuries.
The real story was quite a bit different, however, as this criminal didn’t know the whole thing was caught on video. And the video clearly showed the claimant intentionally slapping the back of the insured vehicle with his hand and then guiding his bicycle to the ground to make it look like he’d been struck by the car.
The claimant retained an attorney to pursue an injury claim, which was denied by Mercury following the police report that included the security camera video taken at the scene. The claimant was ultimately arrested, convicted and sentenced to three months in jail with three years’ probation, and also had to pay a fine, restitution and his medical bills.
Claim #2: Wrong Way Driver
The insured stopped at an intersection in front of a repair van. Suddenly, the two vehicles collided in what appeared to be a rear-end collision, which necessitated police being called to gather statements.
The insured driver and passenger claimed the van driver had rear-ended the insured’s vehicle and both were allegedly injured. However, the van driver’s adamant contention – that he hadn’t caused the accident – led the investigating officer to seek surveillance video of the incident, which he found at a nearby gas station. Sure enough, the footage showed that instead of proceeding through the intersection as expected, the insured driver threw her vehicle into reverse, slamming into the front of the van.
The insured driver and her passenger were subsequently charged with insurance fraud and conspiracy, and the driver was also charged with assault with a deadly weapon … her car. And yes, the claim was denied.
Claim #1: A Not-So-Merry Christmas
Looking to make some quick Christmas cash, the insured and two cohorts staged an accident and filed medical payment claims through Mercury, which were identified as questionable and assigned to the SIU for investigation.
A detailed claims history was compiled for the three individuals, who were then interviewed by SIU investigators. What the investigators found was that each claimant’s story was different, so they began to look deeper. That’s when they uncovered some very compelling evidence that suggested this accident was staged.
The SIU team discovered the insured’s prior claim history showed a loss at the same location with the same facts provided. A confession quickly followed about his latest claim, as well as a description of all the fraud he’d committed on each of his previous claims. All three claimants were convicted and given probation, community service and ordered to pay more than $26,000 in restitution to Mercury Insurance.
“When it comes to insurance fraud, the actions of a few greedy people can have a huge financial impact on the innocent,” said Bales. “Our Special Investigations Unit helps us protect our policyholders from significant rate hikes.
“The public can also do its part to help lower insurance costs by reporting suspicious activity to the National Insurance Crime Bureau.”
ABOUT MERCURY INSURANCE (www.mercuryinsurance.com)
Mercury Insurance (MCY) is a multiple-line insurance organization offering predominantly personal automobile and homeowners insurance through a network of independent agents in California, Florida, New Jersey, Texas, Arizona, New York, Georgia, Oklahoma, Illinois, Michigan, Nevada, Virginia and Pennsylvania. Since 1962, Mercury has specialized in offering quality insurance at affordable prices – core values that distinguish Mercury in the marketplace.
ABOUT THE MERCURY SPECIAL INVESTIGATIONS UNIT
Whether it’s a staged car crash, home arson or exaggerated injuries and suspect medical billing, criminals are creating new ways to cheat their insurance company, necessitating the existence of groups like the Mercury SIU – the CSI of the insurance industry.
Mercury’s SIU was founded 35 years ago, becoming one of the first companies to create an investigative department to combat insurance fraud. Since its inception, the SIU, which employs more than 50 seasoned investigators nationwide, has exposed thousands of fraudulent auto, home and medical claims, saving policyholders millions of dollars annually. The SIU mission: prevent phony payouts, which helps maintain low premiums for Mercury customers.