Insurance carriers are routinely presented with claims for insurance benefits that contain elements of fraud. As a practical matter, fraudulent claims may be classified in three categories: fraud at the inception of the policy; fraudulent enhancement of an otherwise valid claim; and the staged loss. The elements of these types of claims often overlap, and the successful defense of a fraudulent claim for insurance benefits is based on a thorough understanding of the insurance policy and a complete analysis of the claim. Due to the scope of the subject matter, this topic will be addressed in a monthly series of articles. Each will focus on a different part of the investigation process. This first article begins with an overview of the investigative process.
Anthony J. Golowski IIPart 1 in an in-depth series
Insurance carriers are routinely presented with claims for insurance benefits that contain elements of fraud. As a practical matter, fraudulent claims may be classified in three categories: fraud at the inception of the policy; fraudulent enhancement of an otherwise valid claim; and the staged loss.
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