Insurance fraud claims surge in NH

By DAVID BROOKS

Monitor staff

Published: 02-12-2024 10:32 AM

There are many reasons that New Hampshire saw a record increase in insurance fraud claims last year. One of them might surprise you.

“Adobe Pro has been a real game-changer for us,” said Brendhan Harris, Fraud Director at the New Hampshire Insurance Department.

Game-changing, but not in a good way.

The issue, Harris said, is that the software allows documents in the digital format PDF to be easily manipulated. That’s useful in business but also useful for people faking an insurance claim.

“They can create a document that looks so legitimate they’re slipping through the cracks constantly. … They alter medical records, even alter police reports, they alter everything,” said Harris. “It’s a lot more time-consuming to reach out to every single entity to confirm if a record is legitimate or not.”

Compounding the problem, he said, is that many insurance firms have cut back on their own investigation teams to cut costs and increase profits for investors.

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“They have pared down and eliminated a lot of their anti-fraud efforts. They used to have boots on the ground in each state. Now they have what they call desktop investors,” he said. “Trying to investigate a potential fraud claim in the state of New Hampshire when you’re at a desk in Florida, that’s hard.”

Increasingly the work gets passed onto the state Fraud Unit, which has three full-time investigators including Harris.

“The statute says if you suspect insurance fraud you have to make a referral. Then we, my fraud unit, has to go out, do subpoenas, interview people, look at cars, whatever it takes to build cases that are strong enough to stand up to a criminal case,” he said.

In 2023, the Fraud Unit saw a nearly 25% increase in referrals, a record for the department. It received 412 referrals and opened 35 investigations, prosecuting 19 cases of insurance fraud with a total value of $1,584,479.

Automotive fraud, such as pretending that a car is worth more after an accident or faking its theft, remains the most common form of insurance fraud.

There might be another contributing factor to an increase in fraud cases, Harris said, pointing to a survey of consumers by the Coalition Against Insurance Fraud that found younger people are less likely to consider it a crime to submit a fraudulent insurance claim.

The study found that while nearly all Americans over age 55 view insurance fraud as a crime, only about 75% of those between 25 and 44 consider it a crime and just 64% of those between 18 and 24 did so.

Andrew Demers, director of communications for the state Insurance Department, pointed out that if the value of a fraudulent claim goes above $1,000 then the case becomes a felony under state law.

“When you’re a young person who has a felony conviction, that’s going to haunt you on getting jobs, you can’t vote, can’t own firearms. It’s a serious thing for young people to be aware of,” he said.

Since some fraudulent claims, especially for medical insurance, are issued without the person’s knowledge using information stolen online, Harris said it behooves people to double-check any mail they get about a medical payment. If uncertain, call 603-271‐2261, or email consumerservices@ins.nh.gov. For more information, visit www.nh.gov/insurance.