Is The Personal Injury Fraud Claims By Insurers A Rouse To Hide Corporate Profits

 For years personal injury insurance companies have been claiming fraud is getting more and more out of hand. Over the past several years, even with an incredibly poor economy we've seen companies like State Farm have record setting profits of $800 Million in 2009 and $1.2 Billion in 2010.

So with these claims come suspicion as to their motivation. Why would a company and an industry that's doing so well and so profitable claim fraud is killing their profits and causing greater losses to their company??

Profits. Pure and simple.

According to some, the claims of fraud are a "smokescreen to hide padded profits".

This wouldn't be the first time the public trust has been compromised, politicians in hand in order for corporate profits (anyone remember Fannie & Freddie??).

Read more in this great article entitled: Claude Hanuschak: PIP fraud is exaggerated

So when the politicians start with the TV and Radio ads blaming your local doctors and attorneys, remember this blog post and Claude's words... PIP Fraud Is Exaggerated; all because they want to charge YOU higher premiums!

Florida PIP; One Newspaper Call For Repairs - Not Replacement.

The Orlando Sentinel weighs in on the upcoming battle that will surely pit the big business auto insurers against your local doctor and, if you drive a car, against you.

Pointing out that if you "Remove the PIP requirement, motorists will pay substantially more for their health insurance, which increasingly would cover auto injuries. More deadbeats also will drive without insurance, forcing others to pay for their care after accidents".

The Orlando Sentinel is calling for repairs of the PIP system, not replacing the system with something else. "Where it looks like you'll save on auto insurance, you'll end up paying more for health insurance", points out the newspaper.

The auto insurers also would love to replace a diminished personal injury protection (PIP) system with one mandating more expensive — and more profitable — bodily-injury protection.  Let's remember, this is big business and it's all about big profits.  Under the current system, last year (2010) State Farm's profits surpassed the billion dollar mark, up from $900 million in 2009.

So, with profits so high why all the complaints? Well, quite frankly it's a chance to change the rules of the game to favor big insurance even greater than they do now.

The Orlando Sentinel has it right, don't scrap the current PIP program, rather have our legislators roll up their sleeves and fix what's broken in the current system.  And, quite frankly it's not much. No matter what business, industry or profession, you will find a few bad apples.  But to throw out an entire basket of good apples because there are a few bad ones seems like a waste of a lot of good apples.  It's time for our legislature to pick out the bad apples and find out how they got there, then fix that part of the system.

If you had one bad employee would you close your business? or would you retrain or even re-hire a new one?

For more on the Orlando Sentenal's sentiments, click here for their entire article.

FPIB

PIP 'Reforms' Disguise Insurance Industry Profit Grab

Reprinted / reposted from: http://www.sunshinestatenews.com/story/pip-reforms-disguise-insurance-industry-profit-grab

 

 

Proposed legislation writes loopholes into the law to help insurers

Recently, I read a commentary on your site from yet another special-interest group funded by the powerful insurance industry, with a name that sounds as if they are looking out for the interests of Florida’s consumers.

Your readers need to understand, however, that these so-called “consumer groups” are part of the insurance industry’s public relations engine, which is using the seemingly admirable mantra of reducing PIP fraud to disguise their real intentions of making it easier to delay or deny payments on legitimate PIP claims.

The statistics that often are cited are misleading at best. Let’s be clear: PIP fraud is wrong and must be stopped; but Florida consumers are being blatantly misled by these various consumer groups proclaiming that PIP fraud is rampant and is costing all Floridians significantly in what they pay for PIP.
Insurance companies are continuing to earn record profits, and they are continuing to look for ways to reduce what they pay for legitimate PIP claims. And, contrary to representations made by the various consumer groups, PIP premiums have not gone up in years. Clearly, there is no shortage of insurers fighting for your business – just take notice of all the advertisements and solicitations consumers see every day.

To fuel the uproar, consumer groups keep telling us that PIP fraud is rampant because “questionable claims” in Florida are on the rise. But, has anyone ever stopped to ask what a questionable claim really is?

The term most frequently used is in conjunction with data from the National Insurance Crime Bureau (NICB). As the NICB would confirm, questionable claims are simply initial claims referred to them from their member insurance companies based on what those companies believe to be "questionable" or "suspicious." Such claims are not yet determined to be definitive acts of fraud.

In addition, it is significant to point out that when the number of PIP questionable claims in Florida, according to a March 22 NICB report, is compared to the total number of crashes in Florida (as compiled by the Florida Department of Highway Safety and Motor Vehicles), PIP questionable claims represent less than 1 percent of all crashes (2009: NICB – 2,347 PIP QCs/FLHSMV – 235,778 crashes). And, it is important to keep in mind that data from the Florida Division of Insurance Fraud show that only 4 percent of all reported possible PIP fraud claims it receives (about 5,500) result in prosecution.

So, is PIP fraud really as rampant as insurance companies want all of us to believe? No, it is not.

Some provisions in the proposed PIP legislation have nothing to do with fighting fraud and will instead create a potentially unreasonable burden for medical providers and policyholders to get legitimate bills paid and could lead to fewer medical providers willing to treat PIP patients.

One outrageous provision in the proposed legislation would require medical providers and policyholders to submit to deposition-like questioning, examinations under oath, before claims will be paid. Another provision would allow an insurance company to deny a claim if there is a simple typographical error on a bill or in the policyholder’s medical records. And, the law would limit the amount of legal fees the insurance company would have to pay if it is determined to have wrongly denied a claim. How do any of these provisions stop PIP fraud? They don’t.

If the proposed legislation becomes law, many insurance companies will take advantage of loopholes that will be created in order to make it expensive, time-consuming and frustrating for medical providers to treat PIP patients. That is not fair to consumers. Legitimately fighting fraud must be the real target. Please do not fall for the insurance industry rhetoric.
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Cris Boyar is president of Floridians for Fair Insurance. FFI seeks to reform policies in Florida known as “bad faith” insurance laws and to protect Florida’s small-business owners and consumers from the threat of lawsuit abuse.

Claims Of Personal Injury PIP Fraud Are Grossly Exaggerated

Brilliance in just a few words. As in all professions, those that commit fraud are an extreme minority.   They are the proverbial "squeaky  wheel" that gets the oil. That being said, the author of this article points out that PIP fraud accounts for less than 1% of all the insurance fraud relating to automobile accidents.  Yest companies like United Automobile & State Farm continue to pound the legislature with ridiculous claims that fraud is the industry standard rather than the exception to the rule. 

Let's not forget that with all the alleged growing fraud, State Farm still posted record profits of $800 Million in 2009 and $1.8 Billion in 2010.  Wow, who knew that fraud would increase their year to year profits so much ? I wonder how that happened. 

Anyway, here's a link to a fresh little article about the often hidden truths - Click here, read & enjoy

Proposed Florida Legislation Calls For "Fraud Tax"???

Here in Florida, a House subcommittee this morning approved a controversial bill that would limit fees for attorneys who sue insurance companies in disputes about so-called PIP claims...and here we go again.

Insurance companies cry foul when it comes to fraud because they say they are losing so much money due to fraudulent claims.  This year not only were they promoting their agenda regarding PIP fraud and staged accidents, but suddenly sink holes too. 

Please realize that an insurance company is a business like any other. So they try to wield their political influence in such a manor as to gain any business advantage in their market. Remember, they are in business to make a profit. And, there's nothing wrong with that. But when you run a company like State Farm and constantly tell people you're losing money to fraud when in 2009 you made a paltry $800,000,000.00 profit (yes, that's 800 million) and then in 2010 you increase your profits to $1,800,000,000.00 profit (that's 1.8 Billion in profit)...yet you continue to cry to your legislatures that fraud is continuing to harm your business, who do you think you're fooling?


No doubt that fraud should be stopped for no other reason than it's fraud and it's wrong. But if the stated statistics are true, then it seem that with the increase in fraud comes an increase in insurance company profits. I'm not sure how that works, but it seems to be the case.

But with all of the efforts that have taken place, one of the biggest reasons for a change in legislation is because fraud costs the consumers just way too much money...AND it's taking money out of the consumer's pockets. Yet, with all the legislation, with all the hoopla, with all the incredible profits posted by these insurance companies, I have yet to see one of them lower their premiums.  None!

When do the consumers get to save money? How much does someone like State Farm or the others have to profit by to get them to stop raising rates?  Maybe $1.9 Billion and we get a discount?  Excuse me but I won't hold my breath.

The real fraud is that this is a game to the insurance companies. They cry fraud, they get their PR companies to get article after article in the newspapers and stories on TV all to justify their raising your rates...  Good luck to them, let's see if you can make a $2-Billion Dollar profit in 2011. 

Seems like in a down economy, being an insurance company would have been the best bet.  People pay you for insurance and you get to deny their claims until an attorney calls you on it. Now, they want to limit an attorney's ability to protect the rights of citizens. Assuring their ability to increase their profits and rake you over the coals on their way to the bank to deposit their profits.

Here's the link to the original story... Enjoy

http://www.healthnewsflorida.org/top_story/read/state_officials_target_fraud_tax

United Automobile Insurance Company Tactics Get The Boot By The Supreme Court of Florida & Set New Legal Precident

No longer can an insurance company use a "No-Show" at an IME as the basis to deny a claim. Since EUO's are not part of the PIP statute, one can argue that a "No-Show" at an EUO also cannot be used as the basis to deny a claim.

The decision is still hot off the presses as it came down earlier today. To see all the details click on this link Cluster Medical Center a/a/o Maximo Masis v United Automobile Insurance Company