Enlisting policyholders could tip the scale in enacting anti-fraud bills

If you use eBay, chances are you received an email this week encouraging you to sign on to its campaign to limit taxes on and regulation of selling stuff online. Its message is simple: More taxes = more costs for both buyer and seller.

A link in the email takes you to a sample message  you can send to legislators. You just need fill out a brief form with your personal info, and click “submit.”

We have no doubt that such grassroots tactics work. A similar program created by the Coalition a few years ago found that generating as few as a handful of emails to a legislator can make a difference. Legislators do notice email from constituents. Legislators often vote for constituent wishes, and even co-sponsor bills based on support from voters.

That said, why don’t more insurers enlist the support of their policyholders in their own legislative battles when those initiatives serve the public interest?

For example, homeowners in South Florida face steep increases in homeowners premiums thanks to the state’s allowing assigning of insurance benefits and payment of outrageous attorney fees. The outrage expressed by consumers should be turned into a campaign to pressure legislators for relief from related scams.

Drivers in New York face some of the highest auto rates in the U.S., due in part to the state’s loose no-fault laws. Surely auto policyholders would sign on to a legislative campaign if they thought the outcome could put downward pressure on rates. The list goes on and on.

When questioned, insurers don’t always have good answers. Many are reluctant to enlist policyholders out of fear of offending them. Such campaigns also could backfire by inspiring adversaries (lawyers, doctors, roofers, etc.) to aggressively counter other legislative initiatives important to insurers.

I get all that. But it still seems that selectively enlisting policyholders could tip the scale on anti-fraud bills, and help insurers convey that they’re looking out for their policyholders’ best interests.

About the author: Dennis Jay is executive director of the Coalition Against Insurance Fraud.

Families torn apart by relentless pursuit of bogus whiplash claims

Corruption by stealing insurance money can creep up on normally decent people. The opioid-like lure of easy money grinds away at even your deepest-held values, shifting a well-lived life into a corrosive money grab that breaks apart a helpless family when fraud prosecutors come knocking.

Jason Dalley was a personal-injury lawyer. He also was a loyal Little League Coach, respected in the community and a devoted family man.

Andrew Rubinstein was a Ukrainian emigre, and the glue that held his family together amid the weight of personal tragedies. Dalley’s and Rubinstein’s decisions to steal insurance money for a fraud ring in South Florida sliced through families that depended on them.

The duo signed up with a staged-crash ring that siphoned $23 million in bogus whiplash claims from 10 auto insurers in South Florida. All the while, helping drive up auto premiums for honest Florida drivers.

A cartel of medical clinic owners, chiropractors, attorneys and others teamed to fleece auto insurers with inflated and fake whiplash injury claims. Recruiters steered the crash victims to them. Dalley and Rubinstein were key cogs.

Greed caught up attorney

At first, Dalley was a bit player with the ring. He paid kickbacks of $2,000-$2,500 to tow-truck drivers and street recruiters to illegally bring him the crash victims. Medical providers inflated claims for chiropractic treatments, often forging medical records for treatments that never happened.

“The remorse you felt was only after you were caught. The illegal activities … affect every consumer by increasing their annual insurance premium cost,” the judge said.

Dalley filed bogus insurance claims for the crash victims, whether they were injured or not. He helped force large claim settlements with the defrauded auto insurers. The entire ring was hyper-efficient, seemingly invincible. Millions of insurance dollars tumbled down. Everyone got a cut of the money, lining their bank accounts handsomely.

Fraud investigators and prosecutors eventually cracked open the ring, hauling Dalley, Rubinstein and other cohorts into court.

Dalley had lived a clean, respectable life until greed overcame his values. He was involved in community causes, including coaching a Little League team for 15 years in Boca Raton. Be good people and play the game well, he urged the young ballplayers as their ball coach and life mentor.

His wife and three teen sons were devastated when Dalley was convicted. He was in tears when he admitted to the court that he started slowly with scamming until becoming drunk with easy money. He was the family’s rock, dumped into federal prison for a year and nine months. Dalley’s law career also is over. He’s losing his license, leaving his family to somehow make do on its own. Dalley also must come up with $1.8 million in repayment.

Made clinics into puppet operations

Rubinstein took over ailing clinics, installing straw owners to hide his illegal ownership of the puppet operations. The clinics were little more than factory lines churning out bogus whiplash claims.

He spent his wads of insurance money on day-to-day expenses, his family’s home, vehicles and vacations. Rubinstein’s 16-year-old daughter, Michelle, cried as she made a heartbreaking plea to try and keep her father out of prison. Rubinstein held their family together as her mom struggled with mental health problems and alcoholism before suffering a fatal stroke, Michelle told the judge.

Rubinstein had every chance to make a clean living. He’s an Ivy League-educated occupational therapist and former engineer. Instead he kept scamming auto insurers for two years even after learning he was being investigated. Judge Beth Bloom knew sentencing would be hard for Michelle and Rubinstein’s step-son, their family now broken up. Bloom still handed him six years in federal prison.

“The remorse you felt was only after you were caught,” the judge said. “The illegal activities … affect every consumer by increasing their annual insurance premium cost.”

Many consumers complicit with “little white lies,” more Americans need to report scams to fraud hotlines

The header is hardly a typo, nor does it refer to the honest organization called the Coalition AGAINST Insurance Fraud. I’ve talked with many people about my work with that alliance. Often with a smile or chuckle, I’m asked, “Well, is there also a coalition in favor of insurance fraud?” These humorous exchanges made me realize that there IS such a group. It’s informal, and millions of people belong. Many of us may be active members, or at least complicit. 

It seems almost everyone knows someone who has committed, or is committing, insurance fraud. Maybe not a crass arsonist or hardened leader of a large staged-crash ring. Though instead, maybe a co-worker, friend or family member who wasn’t injured, yet made a false workers-comp or bodily-injury claim. Or maybe the person (or ourselves?) who adds just a “little bit” to inflate a claim and compensate for the insurance “hassle,” cover a deductible, or get a new TV that’s better than the one that was stolen from the living room. 

People can be surprisingly tolerant of this crime, and hence members of the “Coalition FOR Insurance Fraud.” At least a quarter of U.S. adult consumers believe it’s okay to pad a claim to make up for the deductible. Nearly 20 percent approve of inflating claims to cover premiums paid in the past. Fully 10 percent believe insurance fraud doesn’t hurt anyone. These could be our neighbors, co-workers, friends and family members. 

So why would someone join this crime-committing group? Nearly seven of 10 people believe people steal insurance money because they feel they can get away with it.

So how many “members” belong to this nefarious Coalition? The U.S. has slightly more than 325 million people. This means 65-80 million U.S. adults could be fine with padding claims, and more than 30 million feel insurance fraud has no impact on them or our society. Given the 150 members of the good-guy Coalition … we’re outnumbered by thousands of percentage points!

Normally honest consumers may claim we, and perhaps even close friends or family, aren’t members of the dishonest “coalition.” Yet how often have we heard others, or even ourselves, suggest someone try a false personal-injury claim to line their bank account? Or we know a co-worker who complains of back pain for years, then falsely claims a “new” workplace back injury? 

And how many insurers pay a claim, knowing the entire claim or a large  portion, may be fraudulent? Yet for a variety of reasons — from getting rid of a nuisance claim to budgetary constraints — the insurer simply pays the claim and quickly moves on. 

Those of us who are attorneys are eligible for “club” membership too. In more than 30 years of insurance practice, many of the worst claims I was involved in had insurance professionals and sometimes defense counsel as claimants. I recall phone calls directly asking how to “maximize” the claim payout, and even insurer employees as well as defense lawyers saying this was their “chance” finally to be on the receiving end of a settlement check. This occurred far too often to be isolated incidents or coincidence. 

Far too many of us may be fraudsters indirectly and be complicit by failing to speak out when we see a scam happening.

Will this blog change the equation? No. But blogging raises issues we may not be comfortable talking about. Maybe this blog incited a moral “twinge” if you made an inflated claim that was a “little white lie.” No one is immune from getting caught up in the world of insurance fraud — directly or on the periphery. Hopefully we may learn and grow more honest — regardless of our role or age. Perhaps the next time we see the “dishonest coalition” in action, we’ll speak up or report a scam to our insurance department’s fraud hotline. We can act instead of turning a blind eye or unhearing ear. 

If we’re willing to take that small step, maybe we can remove one more member from that other “coalition,” and strengthen our own Coalition AGAINST Insurance Fraud. 

About the author: Matthew J. Smith serves as general counsel and director of government affairs for the Coalition Against Insurance Fraud.

Cold callers try to steal medical, financial IDs, threaten to cut off Medicare benefits

Seniors, watch out. A move to prevent your identity from getting stolen actually is breeding those schemes.

Nearly 60 million seniors will receive new Medicare cards without Social Security numbers over the next year. Seniors are getting red, white and blue paper cards with a mix of 11 numbers and digits instead.

HHS is mailing the cards to keep SSNs from the grubby hands of thieves, who use the numbers to filch seniors’ medical and financial identities.

The biggest fear is that swindlers will try and trick seniors into giving up their SSNs or other info during the one-year phase-in period. Medicare ID scams are hardly new, though the momentous shift could breed all manner of chicanery.

Cheaters are cold-calling seniors, lying they’re from Medicare. The seniors are due for a refund on their old Medicare cards, and need to provide their bank info to process the refund, the crooks say.

Or there’s a fee for the new cards, so just hand over your banking or credit-card info and we’ll gladly take your payment over the phone.

Some callers threaten — you’ll lose your Medicare benefits unless you pay up now.

Other times the claimed Medicare rep wants to “verify” the senior’s SSN.

Text and email pitches are reaching seniors as well.

Medicare won’t contact you by phone, text or email about the new cards. The cards also are free, and nor do seniors have to report or verify info.

Yet three of four seniors know little or nothing about the new cards, an AARP survey says. Six of 10 seniors think they must pay a fee. Half might not question a call from a claimed Medicare rep.

Scammers have cold-called seniors for months during the run-up to the switch. Sleazy pitches are picking up speed with the new cards being mailed.

Staying safe is easy:

• Just hang up;

• Sign up for an alert that your new card was mailed; and

• Destroy your old plastic Medicare card when your new one arrives.

The new Medicare cards are here to protect your identity. With common-sense precautions, you can let the cards do their work well.

About the author: Jim Quiggle is director of communications for the Coalition Against Insurance Fraud

Leg amputated after claiming ambushed while helping stranded motorist

Shannon Egeland stopped to help a pregnant woman stranded on a roadside late one summer night near Caldwell, Idaho. It was an ambush. 

Someone snuck up behind, bopped him in the head and shotgunned him. The blast tore into Egeland’s legs. He had large blood loss and shattered bones, forcing surgeons to amputate his left leg.

Or so the former Idaho developer told his disability insurer.

Egeland had his teenage son Ryland blast him in his legs with a 20-gauge shotgun, then left him lying by the roadside in a bizarre insurance scam. Egeland dialed 911 after his son sped off.

He invented the ambush to make a false disability claim to boost his finances. But the Samaritan Scam fizzled. Fraud investigators soon saw through the ruse. 

The attack had no logic or motive — why did robbers leave his wallet, cellphone and fancy BMW behind?

Egeland also bought the death-and-dismemberment disability policy just a week before the shooting. Suspicious timing.

He also lied on the insurance application. 

Egeland had no arrests in the last 10 years, he told Standard Insurance Company. He actually faced federal sentencing for a $20-million mortgage-fraud scheme in Oregon.

Egeland finally admitted all. On top of the insurance con, Egeland hoped the setup shooting would delay his sentencing for the mortgage plot. He finally was handed 10 years. Egeland later received nearly four years for the insurance shooting in March 2018.

“What bothers me the most is my son — the pain is on him,” Egeland said. “If I could take it all back, I would, but I can’t. That will haunt me the rest of my life.”

Fraud fighters have a duty to use reliable data

Like or loathe, the term “fake news” is now part of our national culture. Even the venerable Webster’s Merriam Dictionary now includes “fake news.”

Fakes, frauds and scams are well-known to the fraud-fighting community. Yet how often do we consider the source of information or data we rely upon in our investigation or advocacy efforts?

As a child I remember my father somewhat cynically stating the adage: “Figures don’t lie, but liars make figures.” We often use data and reports to support our positions and advance our goals. As an attorney, I was taught to cite the law and information if you want to prevail. It remains good advice.

But fraud fighters especially owe a special duty to the public to be cautious about what reports and statistics we cite, and even define what constitutes insurance fraud.

A good case in point recently was discussed among insurance policymakers. The battle has raged for many years over whether insurers have the “right” to use aftermarket versus original (OEM) parts in making vehicle repairs.

Proponents argue that aftermarket parts are at least of equal quality, while critics say insurers use shoddy knockoffs to avoid paying for higher-priced OEM parts. The usually impartial Insurance Institute for Highway Safety recently was embroiled in a battle about the safety of aftermarket parts.

A Dallas law firm is handling a case involving injuries allegedly caused by using aftermarket parts. The firm ran crash tests supposedly showing increased risk of injuries to passengers in vehicles repaired with aftermarket parts. The findings ran counter to tests by others, and referenced by IIHS, which issued a news advisory questioning the validity of the law firm’s findings.

This is one example of how statistics can support far-differing positions on issues affecting insurance overall, and fraud specifically. Leaders such as the Coalition spoke to legislators, often citing studies and data, at the recent NCOIL spring meeting in Atlanta.

One debate showed how “reliable” data can support far-differing views. Of growing national importance are Pharmacy Benefit Managers (PBMs). The “Big 3” PBMs control 78 percent of the prescription drug market, with more than 180 million enrollees. One PBM just made national news by announcing Cigna’s plan to spend $54 billion to take over Express Scripts. Combined, they had revenue of about $142 billion as of last year.

Even before this mega-merger was announced, NCOIL speakers cited statistics, data and pricing analysis to favor and demonize PBMs and their impact on America’s health and prescription drug insurance markets. Statistics were cited to praise and ridicule. Certainly, both sides couldn’t have talked about the same data and “facts” … yet they did. The Coalition was asked if we view PBMs as “insurance fraud.”  We’re monitoring the issue, though are carefully researching before taking a stance, if even at all. Why?

First, is the data itself. Today there’s plenty of data on almost any issue. As we consider what constitutes insurance fraud, we seek accurate and verifiable data. Our credibility rests on having good data on which to base a reliable and informed decision. Often that takes time, and willingness to weigh many viewpoints. Having important groups such as NCOIL, NAIC and NCSL as vital parts of the Coalition gives our members an “ear” and “voice” to address these fraud issues on the national stage.

Second, there is a major difference between insurance fraud and abuse. Some practices are disdainful, yet legal, abuses of America’s insurance systems. With hundreds of billions at stake every year, fraud and abuse run rampant. The Coalition uses our 25-year history as a barometer to help decide what to target as fraud versus abuse.

To prove the point, the Coalition recently filed strongly worded comments voicing concern about the Administration’s proposal to authorize  Association Health Plans potentially under sole federal control. The Coalition educated federal decisionmakers using our first-hand experience of seeing tens of thousands of consumers defrauded by fake health plans when AHPs ran amuck in 2002-2004. Citing this sorry history, we urged policymakers to allow all-important state oversight of AHPs in conjunction with federal involvement.

Whether the debate is over AHPs, PBMs, OEMs or another string of acronyms, data can support potentially all sides of a debate. We talk about the importance of SIUs deciding whether a claim is fraudulent only when the investigation is complete, with all the facts. We caution younger adjusters to be thorough to avoid allegations of bad faith.

It’s always wise to be certain that data we rely upon is tested and derived from reliable sources. Or does it represent only the views of a special interest group with an agenda? And, is the issue about insurance fraud, or abuse of our insurance system? America’s insurance consumers rely upon carefully weighed opinions and actions by the Coalition, our members and allies as we protect the public from insurance fraud. To that viewpoint, certainly, the Coalition is committed.

About the author: Matthew J. Smith serves as general counsel and director of government affairs for the Coalition Against Insurance Fraud.

Satisfied claimants good for business – and can help fight fraud

Property/casualty insurers should feel pretty good about themselves after seeing glowing numbers in the latest customer satisfaction report. In fact, J.D. Powers says claimant satisfaction is at an all-time high — and this comes after a couple of years of heavy homeowner disaster claims.

High customer satisfaction is good for business. It promotes goodwill and creates loyalty. Customer satisfaction helps reduce the consumer complaints received by insurance departments, lessening the burden on regulators.

Satisfied customers also can help to reduce the perceived need for claimants to run out and hire an attorney at the first sign of a loss.

And there’s one more reason insurers should continue to work hard to keep customers satisfied: It can help reduce fraud.

When consumers feel they’re treated fairly, they’re less likely to be tolerant of fraud. Research by the Coalition strongly suggests a correlation between satisfied claimants and their attitudes about fraud. After a loss and a good claim experience, policyholders are more likely to look down on friends, family members and co-workers who are considering a scam.

Exerting such peer pressure can be the strongest deterrent to fraud, according to researchers.

Insurers have plenty of reasons to continue to keep claimants satisfied. Let’s hope it’s a trend that will lead to even higher levels of satisfaction in the future, and lower levels of fraud.

About the author: Dennis Jay is executive director of the Coalition Against Insurance Fraud.

Specialist also sticks Medicare with $137M in bogus eye claims

Patients flocked to Dr. Salomon Melgen, looking for relief of serious eye conditions. The West Palm Beach, Fla. eye specialist returned their trust by thrusting needles painfully in their eyes and searing their retinas with lasers. It was a festival of worthless and botched procedures that left patients with damaged eyes.

For Melgen, the payoff was a $136-million filching of Medicare and taxpayers. He became a rich man replete with a luxury mansion until investigators, well, saw through his shortsighted eye ruses.

The Harvard-trained specialist was well-known and sought-after, especially for seniors with eye problems. Their misery became his path to insurance wealth.

Melgen treated up to 100 patients a day. He falsely diagnosed most with debilitating diseases, even when most had no disease. Macular degeneration was his most-common bogus diagnosis. It’s a retina disease that can permanently sap the vision of seniors 65 and older. The prospect of an incurable descent into blindness made patients take whatever treatment the expert in the white coat said they needed.

Painful eye injections

That often meant painfully injecting expensive medicines into their eyes, then billing Medicare. Melgen often had his staff fill out medical charts and diagnoses before he even saw patients. Medicare paid him for 37,075 injections in 2012 alone — more than 100 per day. Tests often were done in just seconds, making them worthless for diagnosing. Melgen’s average insurance haul was more than $23,000 per patient.

Some seniors had a plastic prosthetic eye, yet Melgen billed Medicare for testing and treating serious eye conditions. Other patients had eye conditions that were too far gone to benefit from treatments. Melgen still soaked Medicare with batteries of tests and treatments.

Anna Borgia had painful injections and laser treatments for supposed glaucoma and diabetes-related sight loss. Melgen then botched a surgery that left her nearly blind, she testified. She says she’s confined to her home, listening to the TV and paying drivers to take her to the grocery store.

Developed eye infections

Melgen convinced a 90-year-old woman to have laser treatments and injections. She later said she didn’t need the treatments — she had no eye disease. Patients developed eye infections from injections. Fully one of every 13 patients grew infected. That was “astronomically high,” an expert testified at his trial. Normally only about one in 3,300 patients are infected, experts said.

Randy Frick’s attorney read a letter saying Melgen convinced his 90-year-old mother to get laser treatments and injections. He later learned they were unneeded because his mother has no eye disease.

“She underwent systemic torture at the hands of Melgen,” wrote Frick, who drove his mother to the appointments. “I feel so guilty I have nightmares.”

Melgen played another billing trick on Medicare — give patients partial doses of medicines, bill Medicare for a full dose, then bill again for using the remaining meds in the vile. That turned a $2,000 vial into a $6,000- $8,000 insurance windfall.
Melgen was handed 17 years in federal prison in February 2018.

“I love dancing but what man wants to take a blind woman dancing?” Anna Borgia told the judge.

Surprise, uninsured medical bills drain patient bank accounts

A reporter strikes a nerve with a story that prompted hundreds of news outlets to re-post his saga of a Texas patient’s run-in with a large, uninsured bill for urine testing.

The phone rang. A reporter wanted to interview the Coalition about a problem that’s been vexing medical patients with growing frequency: surprise jack-in-the-box bills for urine drug testing that patients assume their health policy covers.

The investigative story by the respected Kaiser Health News posted a couple of weeks later. A fine reporting job that featured Elizabeth Moreno. The Texas woman was handed a whopping $17,850 lab bill for a routine urine drug test her health insurer refused to pay because the lab was out of her health plan’s network.

In the story, experts described the lab’s bill as “real fishy,” “outrageous” and a “misplaced decimal point.”

The story took off. CNN posted it. So did the Washington Post, NPR and Money Magazine. Soon an avalanche of news outlets re-posted it — more than 420 at last count.

Longtime reporter Fred Schulte had struck a journalistic and human nerve.

Stunned patients with growing frequency are stuck with ruinously large bills when they’re shuttled to medical providers outside their own health- insurance networks.

Their health policy thus won’t pay up, so the patients have to drain their bank accounts or face collections, suits and wrecked credit ratings.

Surprise out-of-network bills are bedeviling patients around the U.S. Moreno’s lab bill is just one signpost of a larger billing problem that can invade almost any medical procedure.

The bills often straddle a fine line from large to abusively large to criminally inflated.

News outlets everywhere wanted to report on a spreading abuse that could land hard on any of their readers’ doorsteps — and bank accounts. Fred Schulte gave them another chance to alert readers.

The Kaiser story isn’t the first, and likely many more news outlets will pull the lid off unexpected and onerous medical charges until reforms lay this problem to rest.

A bill in Congress would prevent surprise bills for patients treated in a hospital.

As for consumer action:

  • Check with your insurer, doctor and hospital before getting treatment if possible. Ask for projected range of costs for planned medical procedures;
  • Ask what provider and work your health plan will cover, and what’s out of network. Anesthesiologists, radiologists and pathologists are common examples of out-of-network providers who may be called into your case without your knowing.; and
  • Afterward, get an itemized bill. Read it carefully, and check for procedures you didn’t receive. Your insurer also may help if you see surprise bills, so contact your insurer before writing any checks. Also see if the hospital has a patient advocate who can help.

There’s no bullet-proof answer, especially if you need fast emergency treatment. Still, any preventive steps might save thousands.

And as for Elizabeth Moreno, her father settled the lab’s bill for $5,000, which he now regrets.

About the author: Jim Quiggle is director of communications for the Coalition Against Insurance Fraud

The march of Millennials: More likely to scam insurers?

Younger consumers are more-likely to tolerate padding claims. Will America’s largest generation grow more honest as they age?

The insurance world is captivated by the rising use of Big Data and artificial intelligence. A technological revolution is upon us, from underwriting to claims to fraud investigations.

In our rush to understand and use these breakthroughs to discover and combat insurance scams, we also must ask how much are we forgetting about the human element that motivates insurance fraud?

Many think the Baby Boomer generation was our nation’s largest population change. That’s correct, as a population surge. Yet in raw numbers, the 75.4 million Millennials have surpassed the 74.9 million Boomers as the nation’s largest generation. As Boomers age and die off, Millennials as a percent of the U.S. population will continue rising in the coming decades.

How does this emerging generation view insurance fraud? The answers may surprise you! An older, though still often-cited, Accenture study of people’s attitudes toward insurance fraud gives some telling insights.

Consumers were asked how acceptable they found it to make claims for phantom lost or damaged goods, or for phantom injury treatment.

Older Boomers almost unanimously (97 percent) found this blatant fraud unacceptable. Fewer consumers found the scams unacceptable among younger age groups until we reached consumers aged 18-24 years of age. Fully 16 percent found those false claims to be completely acceptable! Given the size of the Millennial generation, that suggests 12 million future U.S. insurance fraudsters. Other fraud questions revealed a similar acceptance of insurance fraud by America’s youth.

Will Millennials grow less tolerant of fraud as they age? That’s certainly the question. Current trends don’t seem to point in that direction. A more-recent study found:

Younger respondents, especially young men, were much more likely to view claim padding as acceptable. For example, among males age 18-34, 23 percent agree it is all right to increase claim amounts to make up for premiums, compared with just 5 percent of their older male counterparts and just 8 percent of females aged 18-34.”

The idea that nearly a quarter of Millennial-age males are perfectly fine with inflating a claim should cause concern.

Why should we care? Startups and traditional insurers are looking at “peer-to-peer” models. These app-based insurers often rely on speed more than thorough review of underwriting and claims handling.

One such insurer boasts it paid a claim in a world-record 3 seconds. These new insurers often claim they’ll rely on the “inherent honesty” and “moral attitudes” of Millennials to be honest with insurance dealings — especially if the insurer donates a percent of profits to charity.

More-seasoned fraud investigators may counter: “True, unless the fraudsters view themselves as the more-deserving charity!” 

But perhaps most important, we need newer consumer-attitude studies to best grasp Millennial attitudes about fraud. A study by the Coalition will be released later this year. It will provide much of that needed guidance.

Millennials are the future policyholders in America. They’ll form the largest block of insurance buyers in our nation’s history. While Big Data and AI are important to fighting insurance scams, let’s remember that it’s we humans — based on our morals and values — who decide whether to commit insurance fraud.

About the author: Matthew J. Smith serves as general counsel and director of government affairs for the Coalition Against Insurance Fraud.