friday, March 27, 2020
Coalition: Corona P-C scams coming, could hit hard
March 27, 2020, Washington, DC — Americans are reeling from the shock of COVID-19. The pandemic could last for months. If it does, the financial damage to millions of consumers and businesses across the nation will rapidly accelerate. As personal savings dwindle and falling profits push businesses toward bankruptcy and lower than expected earnings, many good American citizens and corporations could make bad decisions to seek rapid payouts through insurance scams. … more info > Property Casualty 360
Coalition, Carolina jointly alert consumers about corona cons
March 26, 2020, Raleigh, NC — North Carolina Insurance Commissioner Mike Causey joins the Coalition Against Insurance Fraud in urging residents to be on guard against scammers preying on fears related to the coronavirus pandemic. “Crooks will stop at nothing to scam the public, including using the coronavirus as a means of stealing your money, or worse your personal identity,” Causey said. “If you get an unsolicited visit, call or … more info > The News Herald
Georgians allegedly fake food poisoning at restaurants
March 26, 2020, Gwinnett County, GA — A Gwinnett County man is behind bars, as police continue searching for nine more suspects who they believe played a role in a food poisoning insurance fraud ring. The initial investigation focused on two suspects but quickly expanded into what what was discovered to be a ring of individuals allegedly using the guise of a food allergy compliant at local restaurants throughout six Georgia Counties to defraud medical insurance companies, authorities told CBSS46. … more info > CBS 46
Texas court debates duty to defend in fraud cases
March 27, 2020, Austin, TX — Traditionally, when analyzing if an insurer has a duty to defend, Texas law requires courts to apply the “eight-corners rule,” comparing the factual allegations in the four corners of the pleadings with the language within the four corners of the insurance policy. When this rule is applied, courts focus on the factual allegations that show the origin of the damages rather than on the legal theories alleged and give a liberal interpretation to the allegations in the petition. These two … more info > Mondaq
Feds allege major insurer inflated Medicare claims
March 26, 2020, Miami, FL — The Department of Justice has sued Anthem, alleging that the health insurance company knowingly submitted inaccurate medical codes to the federal government from 2014 to 2018 as a way to get higher payments for its Medicare Advantage plans and turned “a blind eye” to coding problems. Why it matters:This is one of the largest Medicare Advantage fraud lawsuits to date, and federal prosecutors believe they have more than … more info > AXIOS