Insurance: USA companies reviewing past "slip and fall" cases for fraud patterns
The USA's National Insurance Crime Bureau (NICB) says that "slip and fall" claims targeting businesses and their insurance companies are beginning to be examined more carefully for potential fraud.
An analysis of questionable slip and fall claims submitted by NICB member companies showed a 57 percent increase in the number of referrals over the past two and a half years.
More than 4,600 questionable claims were received in 2008, 2009 and the first half of 2010.
Most of those claims were tied to commercial policies.
"While many people have legitimate accidents in stores and businesses across the country, we've seen a growing number of cases that have some indication of potential fraud," said Joe Wehrle, NICB president and chief executive officer.
He says that investigations have produced evidence of organised criminal gangs "making a good living staging accidents."
Supermarkets are a favourite target: ""A typical slip and fall case may involve two people going into a big box store or retailer, and splitting up. When the [pair think they are not being watched, one of them] pulls out a small bottle of liquid, pours it on the floor and then pretends to fall on the floor. The partner runs to assist and tells everyone that he witnessed the fall," says Wehrle.
"The bad news is that many retailers are self-insured and they look at this as a cost of doing business - they'll write a cheque without investigating. Based on what companies have told us, we think that adds up to millions of dollars in unwarranted payouts."
NCIB wants them to work with the insurance sector to help stamp out this kind of fraud.
And it's a growth industry: the number of slip and fall questionable claims submitted to NICB went from 325 in the first quarter of 2008 to a high of 565 in the fourth quarter of 2009. In the first half of 2010, there were 997 slip and fall claims referred to NICB for further analysis, the body says.
Download PDF version of this page