Multi-Billion Dollar Medical Fraud Problem Examined In NICB ‘The Informer’

Reflections 20 Years After 9/11 Special Feature

The National Insurance Crime Bureau (NICB), the insurance industry’s association dedicated to predicting, preventing, and prosecuting insurance crime, announces the release of its latest issue of The NICB Informer. In the Fall edition, we take a closer look at medical fraud and its many forms—from inflated b****** to fraudulent physicians and staged accident rings.

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“The U.S. health care system is a vast network of patients, providers, facilities, insurers, medical products, and related services,” said David Glawe, president and CEO of the National Insurance Crime Bureau. “Because of the system’s massive size and complexity, it is also an attractive target for insurance fraud criminals.”

Crooked physicians, attorneys, and patients commit insurance fraud by submitting false and exaggerated claims. Fraudulent physicians fabricate their credentials, bills, and even their offices without providing treatment. Some unscrupulous providers even pay patients to participate in staged accidents and submit false medical claims to insurers for services never rendered.

NICB’s medical fraud expertise is unparalleled. In-depth articles in this edition range from personal injury protection (PIP) doctors, workers’ compensation and slip and fall since COVID, emerging trends in health care fraud, and crime trends surrounding durable medical equipment.

“The FBI estimates that health care fraud results in tens of billions of dollars in losses each year,” added Glawe. “Unfortunately, we all pay the price for these crimes in the form of higher premiums and out-of-pocket expenses.”

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Within this issue, we also remember 9/11. Twenty years ago, nearly 3,000 Americans lost their lives in the September 11 terrorist attacks. NICB agents, who are former law enforcement and first responders, have kindly shared their memories in a special feature in this issue.

“Among those lost were more than 400 brave first responders, who ran toward certain danger in a valiant effort to save whomever they could,” stated Glawe. “NICB acknowledges and thanks the brave firefighters, police officers, and members of our armed services who  sacrifice so much to keep our country safe each and every day.”

The NICB Informer is aimed at providing insurance industry executives with anticipatory intelligence to help identify risks and emerging threats to the industry. Anyone interested in receiving digital copy notification can sign up or send an email to TheNICBInformer@nicb.org to be added to the distribution.

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