Journal of Insurance Fraud in America

Social inflation has been a hot topic in the insurance industry and among consumer advocates for several years. The concept generally refers to the alleged rising costs of insurance claims from increased number of civil lawsuits, larger jury verdicts, and the general favoring of plaintiffs in civil litigation.

by Jim Patillo & Jordan Loper | September 2020

The chiropractic profession has been a primary provider of treatment for musculoskeletal conditions over the past 125 years. I have witnessed amazing results, especially in personal injury and workers compensation. I have also seen inadequate delivery of treatment, phantom visits, and treating fake injuries through my time as an expert witness testifying in court cases. Read article.

by Dr. G. Steven Baer, DC, DABFP, DACBOH | August 2020

Property-casualty insurers seem mostly satisfied with their anti-fraud efforts, making few major changes in their SIU operations since the Coalition’s last study in 2017.

That’s the news from the Coalition’s latest biennial benchmarking study of how anti-fraud units are structured, operate or get results. Some 40 insurers took part.

by DENNIS JAY | July 2020

Telemedicine once was limited to delivering healthcare services to patients who live in rural or isolated locations, and patients with limited mobility. With the COVID-19 pandemic the scope of medical services delivered via telemedicine technology has suddenly exploded. 

Telemedicine can involve service delivery by phone, audiovisual, or digital such as with Fitbit data. It always had great potential to make healthcare accessible to more people. But its use was hindered by a national patchwork of restrictive rules, regulations and laws. They governed privacy, the type of healthcare practice, and equipment used for communication between patient and doctor. Read article.

by THOMAS E. FRAYSSE, Esq. | June 2020

Shadowy organized criminal networks lurking in far-off lands pouncing on unsuspecting members of the public in safe, western societies loom large in the imagination of action film makers and thriller writers.

Far from the stuff of crime drama, they’re real and major threats. Transnational crime networks are exploiting our connected global economy and digital transformation with growing impact. We are witnessing the continued rise of vast criminal networks that stretch across borders throughout the globe. Read article.

by DENNIS TOOMEY | May 2020

Those of us in the world of fighting insurance fraud have used the word “risk” throughout our careers. But do we ever really stop to think what that word means, and all it entails for our profession? The viral pandemic of COVID-19 has brought this word into the daily vocabulary of our nation, and the world.

There will be many long-term lessons to be learned when we emerge into a post-COVID-19 world. One of them should be for us to pause and consider what “risk” really means in the battle against insurance fraud. Read article.

by MATTHEW SMITH, Esq. | April 2020

During the previous economic downturn of 2008-10, consumers in the U.S. worried about the potential loss of jobs, their homes and life savings. This time around, face those stresses, and potential for loss of life as well.

No one knows the full dimensions of the economic and social crisis facing Americans in the months ahead. But if we learned anything from the calamity of 2008-2010, the frequency and severity of fraud are about to increase — and possibly in a big way. Read article.

by DENNIS JAY | March 2020

Recent reforms in Florida seek to reverse a rising tide of fraud and abuse stemming from storm repair claims that have sharply driven up homeowner premiums around the Sunshine State.

The debate circled around a controversial practice known as Assignment of Benefits (AOB). This is the assigning to a home contractor or other third party of a policyholder’s right to receive post-loss insurance benefits or make claims. Basically, the contractor “steps into the shoes” of the insured, files a claim with the insurer to cover the cost of the repairs performed by the contractor, and handles all claim negotiations with the insurer. Read article.


For the first time since our founding more than 27 years ago, the Coalition Against Insurance Fraud has a new Executive Director. I am humbled and honored to serve in this role.

I pledge to do my best to lead our Coalition forward. Following the pathway Dennis Jay has led so ably will not be easy. We owe a tremendous debt of gratitude to Dennis, and our many other remarkable leaders. They have blazed the trail for the Coalition, and anti-fraud efforts across our nation. Read article.

by MATTHEW SMITH, Esq.| January 2020