Insurance Fraud

Updated May 2017

Dale Dixon of the Better Business Bureau wrote an article on May 6, 2009 in the Idaho Statesman that told only half the story of Insurance Fraud.  When dishonest people cheat insurance companies, they will pass the loss onto us and we will all pay a bit more for our insurance.  I agree it is terribly wrong, but the other half of insurance fraud, when an insurance company cheats an Idaho citizen, trickles down to the taxpayer probably way more significantly than the other fraud raises premiums.  The more important harm is the financial blow, sometimes fatal financial blow that is inflicted on Idahoans when an insurance company cheats an Idahoan.

 

I went to law school as a naive young man.  I had various ideas about where I wanted my legal career to go, but I was firm in my resolve that I would never be one of “those dirty injury lawyers.”  Fate and insurance fraud would change my opinion. During law school my wife caused an auto accident that thankfully caused only minor injuries but resulted in several large medical bills for us.  I asked my auto carrier (a large and well respected insurance company) if I had coverage for our medical expenses and they lied to me.  Twice.  After several months, much anxiety and frustration, and speaking to anyone I thought might know, I was told that PIP or med pay coverage would cover our medical expenses even though my wife caused the accident.  I searched my policy and found that I had been faithfully paying for $10,000 per occupant of that very coverage.  Finally, armed with knowledge, I confronted my insurance company again and they promptly paid our bills, (after some of the medical bills had been turned over to a collection agency).

 

While not tragic, this experience with insurance company fraud helped me realize that good honest people really need help and that you cannot rely on a company (even your own) to tell you what you need to know.  My resolve to avoid injury law was bending.  I graduated law school in the recession of the early 1990’s and could not pass up my first job offer even though the firm’s practice included helping those injured in auto accidents.  In a few years of this work I heard my clients frequently tell of being the victims of the same and other lies from insurance companies.  The transformation was complete and I was ready, willing, and now proud to be called a true blue injury lawyer.  As an injury lawyer, I love the fact that we can take a client from any economic or social background and put them in a fair fight to help a multi-billion dollar insurance company keep its promises with the citizens of Idaho.

 

I am bothered by articles like Mr. Dixon’s that focus only on Human on Corporation insurance fraud and ignore the Corporation (Insurance Company) on Human variety insurance fraud.  In his defense, Mr. Dixon relied in part on statistics and information provided by the Idaho Department of Insurance.  The Idaho Department of Insurance was established to regulate Insurance Companies and should be the state agency to protect Idahoans and help keep the insurance companies honest.  However, over the years I have seen or heard various Idaho Department of Insurance pubic service announcements warning of the cost and evil of human on corporate crime (commonly known as insurance fraud) but nothing on corporate on human crime.  I have wondered why our tax dollars are used to protect these mega insurance companies, mostly out of state corporations, while seemingly ignoring the protection of Idaho citizens.

 

Don’t get me wrong.  I hate human on corporation fraud probably much more than most people do.  That fraud, and mainly its reputation, ruins it for good honest people who make legitimate insurance claims.  Because of fraud and its reputation, the insurance claims department can justify a policy treating all claims as if they are fraudulent.  My work in helping people navigate the insurance claims process is significantly more difficult because of a very small minority that have tried to cheat the insurance companies. I personally know many honorable and honest people working in the insurance industry and am in no wise saying the whole industry is corrupt. I see the worst cases and don’t hear from people when their insurance claim goes well.  But if you don’t believe Corporate on human insurance fraud can and does occur in Boise Idaho you should read the story of Cindy Robertson.  The Idaho Supreme Court, the trial court judge and the Boise jury all had harsh words for a major insurance company who had a plan to save money using bogus medical reports to deny valid claims on Idaho citizens over and over and over again.

 

In addition to the Idaho Department of Insurance and the Better Business Bureau, each insurance company has experienced claims adjusters, lawyers, and, dedicated anti-fraud units to protect the corporate assets.  The insurance claims process is far from an honor system and thankfully most people dumb enough to cheat on an insurance claim get caught.  However, all too often, the only thing standing between corporate fraud from an insurance company on an Idaho citizen is one of those “dirty injury lawyers.”  Thankfully, there are many honest injury attorney’s who will give you a free consultation and give you the information you need to handle your own claim with confidence or will represent you and charge you a fee only if they recover money for you.  Yes, there was a local injury lawyer who was recently caught cheating, but he was discovered, and prosecuted and is not able to practice law right now.  I know most of the injury lawyers in Boise and believe they will be honest because it is the right way to live, not for fear of losing their ability to practice law.  When was the last time you heard of an insurance company losing its right to work, even temporarily?

 

My point is that insurance fraud should be examined from the full view and not only the side that has the ability and the resources to protect itself.

 

Scott Lundgreen