OUR OPINION: Insurers aggressively should pursue the con artists
The lawsuit that Allstate Insurance recently filed in federal court in Miami may be bad news for the defendants -- tow-truck operators, chiropractic clinics, auto-body shops, some policyholders and others -- but it could be a good omen for policyholders. It definitely will be if it emboldens insurers to aggressively pursue fraud.
Staging accidents
The lawsuit alleges that the defendants collaborated in staging 17 auto accidents -- and possibly more -- and then filed fraudulent insurance claims. The lawsuit isn't a first. Allstate and other insurers do go after businesses and policyholders when they suspect cheating. More often than not, though, insurers find it easier to pay the claim and move on. That's because lawsuits are messy, expensive and time-consuming. Worse, the outcome of a jury trial can be unpredictable. In South Florida, even cases where the evidence of fraud is overwhelming have ended with insurers leaving the courthouse in shock and disbelief because of an unfavorable jury verdict.
As a consequence, many insurers are overly cautious about going to trial. Too often it is easier to pay than fight. The ultimate losers in this game of chicken are honest policyholders. They end up paying premiums inflated by the cost of fraudulent claims. This is why it is encouraging when an insurer goes to court to challenge an alleged bogus claim. Frankly, we wish it would happen more often.
The Allstate case involves an alleged network of businesses that brazenly and repeatedly filed claims in a scheme to steal from insurers -- and indirectly from policyholders. One driver would ram another driver's car. Both were part of the scam. Both would file claims for damages and medical bills, and the insurance companies would dutifully pay.
In these cases, the insurance companies paid out tens of thousands of dollars. Allstate realized that something was wrong when representatives noticed that the same cars with the same damage turned up in multiple accidents. The company investigated, gathered evidence and hired a lawyer to bring suit.
Billions lost
Whatever the outcome, the lawsuit sends a message to the scammers that they could end up in court and lose their businesses. There are other benefits, too. Once they're busted, the network of con artists has to cease doing ''business,'' or at least take extraordinary precautions to continue. If all insurers aggressively pursued fraud -- or even just a majority of them -- they could significantly raise the stakes for the thieves to stay in business.
Prosecutors say relatively few groups engage in organized fraud, but they steal billions each year from insurers and honest drivers. Insurers should consider prosecuting scam artists as an investment that results in lower costs for their business and lower premiums for customers.
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