nicb 2 fraudsmart sm catastrophe fraud nicb nicb 3 what is a catastrophe? to insurers: a catastrophe...

39

Upload: stewart-thomas

Post on 12-Jan-2016

219 views

Category:

Documents


4 download

TRANSCRIPT

Page 1: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,
Page 2: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 22

FraudSmartSM

CATASTROPHE FRAUD

NICBNICB

Page 3: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 33

What Is a Catastrophe?

To insurers:

A catastrophe is a single incident, or series of related incidents, causing insured property losses totaling more than $25 million

NICBNICB

Page 4: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 44

NICBNICB

Total Insured U.S. Losses Due to Catastrophes Since 1999

Page 5: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 55

Risks We Face Floods occur in all 50 states and US territories At least 50 million homes may be located in counties at

significant risk for earthquakes On average, 5 hurricanes strike the US every 3 years Wild-land fires Tornadoes affect almost every state 65 active or potentially active volcanoes exist in the US Landslides occur in every state Technological or man-made hazard like nuclear

accidents or consequences of terrorism Loss of life and property resulting from fire far exceeds

that of all other natural disasters, combined

NICBNICB

Page 6: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 66NICBNICB

Most Costly Insured Catastrophes

Page 7: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 77

                                                            

NICBNICB

Highest Insured Catastrophe Losses

Page 8: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 88

                                                            

NICBNICB

Page 9: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 99NICBNICB

Tornadoes in USA

Page 10: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1010NICBNICB

Page 11: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1111NICBNICB

Page 12: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1212

NICBNICB

NICBNICB

Page 13: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1313

NICBNICB

NICBNICB

Page 14: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1414NICBNICB

Page 15: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1515

NICBNICB

NICBNICB

Page 16: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1616

NICBNICB

NICBNICB

Page 17: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1717

NICBNICB

Most Costly Hurricanes

Page 18: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1818NICBNICB

Page 19: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 1919

                                                              

NICBNICB

Page 20: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2020

Copyright © 2002, South Florida Sun-SentinelNICBNICB

Page 21: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2121NICBNICB

Page 22: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2222NICBNICB

Page 23: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2323NICBNICB

Page 24: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2424NICBNICB

Page 25: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2525

10 Most Costly US Earthquakes

Year State Property Damage

1994 CA (Northridge) $15,300,000,000 1989 CA (Bay Area) 7,000,000,000 1971 CA (San Fernando) 553,000,000 1964 Alaska 500,000,000 1987 California 358,000,000 1992 CA (Southern) 92,000,000 1992 CA (Southern) 66,000,000 1952 CA (Kern County) 60,000,000 1933 CA (Long Beach) 40,000,000 1983 CA (Central) 31,000,000

NICBNICB

Page 26: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2626

EARTHQUAKE FACTS:Risk and Insurance Issues

39 states in this century have experienced damage from earthquakes

90% of Americans live in seismically active areas

25% of homeowners in California have earthquake insurance

NICBNICB

Page 27: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2727NICBNICB

Page 28: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2828NICBNICB

Page 29: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 2929NICBNICB

Page 30: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3030

After a Disaster…

There is a simultaneous, massive volume of large complex claims

Claimants are under extreme pressure

Insurance companies are under pressure to settle claims quickly

Exceptional media coverage exists

NICBNICB

Page 31: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3131

Working Conditions

Lack of telecommunications No office or temporary office May not be from local area No accommodations No utilities

NICBNICB

Page 32: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3232

Claim Volume

Northridge earthquake - 430,000 claims

Hurricane Andrew - 161,711 State Farm claims alone

NICBNICB

Page 33: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3333

Cat Fraud Indicators and Scams

Fraudulent claims appear for theft, breakage or water damage due to non-disaster coverage.

Items claimed are not available for viewing because the items are “stored with friends”.

Many collectors do business out of their homes and claim goods under their homeowners’ policy.

Medical claims show up later from “friends” visiting during the disaster.

There are no carpet indentations from claimed items.

Claimed items would not fit into the available floor space.

NICBNICB

Page 34: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3434

Cat Fraud Indicators and Scams

There is no debris from claimed items. Renters making claims as owners. Owners claim rental contents. Vacant rental property claimed as a residence

with the missing contents claimed to have been thrown out.

Agents/adjusters requesting and receiving referral fees.

Property is fully insured, but victim still applies for and receives an SBA loan or FEMA grant.

Claims denied due to a lack of coverage are re-submitted after the coverage is purchased.

NICBNICB

Page 35: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3535

Cat Fraud Indicators and Scams

Back to back disasters where unrepaired damage from the first disaster is claimed again in the second.

Recycling inventories from house to house, (secure debris before it can be passed on).

Relocation and moving expenses claimed - claimant never moves or claimant rents from self.

NICBNICB

Page 36: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3636

Contractor & Provider Indicators Do not maintain a local office or have a local phone number. Doesn’t have proper identification. Are not able to provide references. Want “cash” or payment up front. Contractor asks for a large cash down payment. Have inadequate equipment to perform the job. Arrive at the loss site without being solicited. Offer below market prices that are “too good to be true”. Offer cash incentives to get the job. Estimate is very general….Lump sum. Is reluctant to provide a written contract specifying the exact

work, costs, supplies and start/completion dates. Are not bonded or are under-insured and are not licensed or

are newly licensed. Beware of repair personnel who claim to be certified or

affiliated with any state or federal emergency program.

NICBNICB

Page 37: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3737

Do not let your catastrophe

become a disaster

Do not let your catastrophe

become a disaster

NICBNICB

Page 38: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,

NICBNICB 3838

CAT FRAUD

Page 39: NICB 2 FraudSmart SM CATASTROPHE FRAUD NICB NICB 3 What Is a Catastrophe? To insurers: A catastrophe is a single incident, or series of related incidents,