First Look - Summer 2020: Insurance Newsletter

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According to the FBI, “The total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year. That means Insurance Fraud costs the average U.S.family between $400 and $700 per year in the form of increased premiums.” https://www.fbi.gov/stats-services/publications/ insurance-fraud (Retrieved on April 14, 2020). According to the NICB (National Insurance Crime Bureau), “[a] good number of potentially fraudulent claims are paid each year without being investigated due to the desire and requirements to make payments in a timely fashion and the difficulty in proving fraud. As a result, we only see a small percentage of those claims—and an even smaller percent are ever prosecuted.” https://www.nicb.org/news/blog/just-how-much-fraud-there-p-c-industry (Retrieved on April 14, 2020).

An effective tool for claim investigation is the EUO (Exam¬ination Under Oath). This issue is designed to provide a “First Look” at EUOs, from EUO notice requirements, through some ways to use EUOs, to pitfalls that can occur from their usage. Katherine Smith’s article will provide EUO notice requirements and other practical considerations, while Mitch Moore’s article will discuss the delicate matter of SIUs and working with law enforcement during investigations. Gregory Jackson’s article outlines one case in Kentucky where an EUO was used effectively, and the need for support such as that found in an EUO in some aspects of Kentucky PIP (personal injury protection) claims...

Please see full Newsletter below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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