Coalition Against Insurance Fraud: Rapid National Response Urged To Head Off Coming Wave of COVID-19 Insurance Scams

Targeted News Service (Press Releases)

WASHINGTON, April 11 -- The Coalition Against Insurance Fraud issued the following news release:

Urgent and coordinated national planning must accelerate to head off a potential surge of bogus claims by hardpressed consumers and business owners if America's COVID-19 shutdown continues unabated, five national anti-fraud leaders agreed in a history-making webinar this week.

Nearly 3,000 people coast-to-coast attended the largest anti-fraud event in U.S. history. The anti-fraud community is rapidly planning for possibly America's largest claims crisis ever. The webinar was a major information-sharing step forward.

Webinar presenters: Dallas Barnes, President, IASIU ... Joe Wehrle, President & Chief Executive Officer, NICB ... Trinidad Navarro, Insurance Commissioner, Delaware ... Michelle Rafeld, Assistant Director, Fraud and Enforcement, Ohio Department of Insurance ... Matthew J. Smith, Esq., Executive Director, Coalition Against Insurance Fraud.

Key action points from the webinar:

Insurer SIUs

SIU staffing: SIUs must address new technology to investigate and communicate by remote with policyholders, and within the SIU. New tech approaches may change how insurers investigate for years to come.

Vendors: Verify that SIU vendors are properly staffed, and hired only qualified and vetted personnel amid the rush to staff up.

Fraud to expect: Vehicle road traffic may be down, though more staged crashes will happen. Medical networks will seek regain lost income with medical scams. Bogus contractors also may try to convince homeowners to "disinfect" their homes.

Global: The U.S. is a month behind European nations in COVID-19 spread. We must work with global partners in sharing trends and fraud indicators.

Law enforcement/international

Global reach: COVID-19 scams are fast-emerging around the world, often aimed at the U.S. Thefts of cargo loads of sanitizers, gloves and other safety equipment also are happening. The Justice department is making COVID-19 cases a top priority.

Interpol has arrested 100 people in 90 nations for selling fake masks and other equipment.

Many people will commit insurance crime to steal peoples identities. NICB is focusing intently on identifying and pursuing COVID-related scams as soon as they appear.

Moving fast is vital. Fraud fighters must be quickly ready to present their best cases to state and local prosecutors to stem the claim influx.

From Delaware's perspective

The COVID-19 scam surge knows no boundaries. Scams are only a matter of time. Yet getting prosecutors to take cases will be a challenge. Consent decrees may be one fast-track solution.

It's likely that New York City, Louisiana and parts of California will be among the nation's hot spots of COVID-19 scams going forward.

Seniors are especially at risk. One scammer went into a store claiming to be from "Health Services." The person tested people for COVID-19 symptoms, promising the their Medicare or Medicaid would cover the cost. Also, interrogatories about travel insurance are being conducted in Delaware.

State regulators

Information sharing:State regulators must rapidly share information among each other in concert with the NAIC's Antifraud Task Force.

Regulators must work with insurers to fast-track case referrals to the state attorney general or other law enforcement.

Onboarding special prosecutors can add focus and force to COVID-related cases.

Schemes are violating state and federal laws, so partnering with varied state and federal law-enforcement agencies also will be important.

And consider more civil actions if over-stretched prosecutors are unavailable.

Big picture

Insurance fraud is worldwide, including expected COVID insurance scams.

The potential claim wave will cross all lines. Auto giveups ... bogus workers-comp injury claims by home-bound employees. How do you investigate with no witnesses? BI debates will increase over what's covered. Fraud fighters need a voice in those discussions.

Expect a rise in litigation involving issues such as insurer duty to defend.

Short-term health policies are being falsely marketed on the health-insurance side.

Fraud fighters must educate policyholders with deterrent fraud warnings. It sends a message to scammers. If they think we're onto them, then maybe they'll think twice.