Originally posted by Golf66
Not a lawyer but was a PI for a while - ironic that the companies hardly ever investigate fraud.
They never investigate the right people either. All the cases I got were on individuals who were faking injuries. They need to go after the people
who make an industry of it. ... That can make millions over time.
Think they only investigate about 5% of the claims on average.
The problem with medical fraud is not the insurance companies. It is the prosecutors. Medical fraud is a) difficult to understand and b) difficult
to prove. I know of what I speak.
The reason the insurance companies don't investigate fraud civily , it could cost $10,000 or more to fight a $1000 fraud. Then you have local judges
that give the attornies 3 times their fee because it was "complicated" and the attorney has argues he needs a bonus. Since it is the evil insurance
companies who pay, judges are loose with their money. The insurance company cold lose $30,000 fighting a $1000 case. It is not economically
Insurance companies are now fighting more fraud by educating the prosecutors. It is a long process but it is happening. Look at Florida recently. .