Fraud Articles

HIMI Gets Underwriting Authority From Lloyd’s

HEMIC Insurance Managers, Inc. (HIMI), a subsidiary of Hawaii Employers’ Mutual Insurance Company (HEMIC), now has the authority to underwrite Excess & Surplus Property on behalf of Lloyd’s of London, the world’s leading insurance market. This extension of HIMI’s existing coverholder status with Lloyd’s offers agents access to more underwriting facilities on which HIMI has binding authority. Along with Excess & Surplus Property, HIMI also underwrites its Employment Practices Liability Insurance program through certain underwriters at Lloyd’s. This expands HIMI’s portfolio of programs to provide additional insurance options to a select group of preferred agents and the business owners of... Read More

What To Do When You Suspect Claimant Fraud

You heard a rumor. You got a tip. Or you noticed something that made you wonder whether an employee’s claim is a bum steer.The primary precaution is the common sense need to be discreet so you don’t alert the suspected employee before your suspicion is investigated. There are two important reasons for discretion. First, many injuries that appear suspicious are proved legitimate after thorough investigation. Keeping your suspicions confidential protects your employee from unnecessary embarrassment and stress.  Second, once a dishonest employee is aware of your suspicion, he/she is more difficult to catch. Appropriate action on your part protects innocent... Read More

Employer fraud: a $30 billion price tag?

When the talk turns to workers comp fraud, the default assumption is that the employee is the culprit. In reality, employer fraud is a huge problem, of a scope that many in the industry would say dwarfs claimant fraud. According to Loretta Worters of the Insurance Information Institute in a recent article in the San Antonio Business Journal, premium fraud may cost the insurance industry as much as $30 billion a year. In the same article, Dennis Jay of the Coalition Against Insurance Fraud suggests that premium fraud might be committed frequently because there is little enforcement. In describing the nature of... Read More

Claim Fraud Warning Signs

Watch for these warning signs. Especially in combination, they are the most typical characteristics of fraudulent claims, although legitimate claims may have them too. Look for these signs: THE EMPLOYER Is cutting back hours or downsizing and laying off employees Notified employee of poor performance, tardiness, etc. THE EMPLOYEE Is involved in seasonal work that is about to end Has taken unexplained or excessive time off prior to claimed injury Is disgruntled, soon to retire, or facing imminent firing or layoff Is experiencing financial difficulties Has a history of drug or alcohol abuse Has other family members who receive workers’... Read More