BI’s Article search uses Boolean search capabilities. If you are not familiar with these principles, here are some quick tips.
To search specifically for more than one word, put the search term in quotation marks. For example, “workers compensation”. This will limit your search to that combination of words.
To search for a combination of terms, use quotations and the & symbol. For example, “hurricane” & “loss”.
CHICAGO-Insurance fraud is just one part of a wider pattern of economic crime that spans a variety of schemes from money laundering to telemarketing fraud and costs an estimated $800 billion to $1 trillion a year, one expert says.
Losses from economic crime worldwide are nearly double the estimated $500 billion in worldwide drug trafficking proceeds, said James Vaules, director of governmental affairs for Trans Union National Fraud Center, a Horsham, Pa., unit of the credit reporting company.
The explosion of new technology-from computers to cell phones-and the breakup of the former Soviet Union are major factors in the growth of many frauds, Mr. Vaules told an audience at the annual meeting of the International Assn. of Insurance Fraud Agencies in Chicago.
"Technology is probably the single largest contributor, along with the political changes in Europe," he said.
The political changes have created fertile new territories for scams and have brought new organized criminal groups to the United States.
Technology, meanwhile, not only has created new opportunities for crime, such as cell phone fraud, but it also has made con artists' lives easier, he suggested.
Not long ago, for example, check forgers had to be "artists": One could disagree with their actions but had to admire their skill, said Mr. Vaules, a former FBI agent. Now, "anyone can do it in half an hour" with a computer, he said.
Insurance fraud accounts for a relatively small piece of overall economic crime in the United States, generating an estimated $140 billion in losses, including $110 billion in health care fraud, $20 billion in property/casualty-related scams and $10 billion in workers compensation fraud, according to Mr. Vaules.
Other categories produce bigger losses, he said. These include:
Financial crimes, generating $375 billion in losses and including money laundering-the biggest contributor with $300 billion in costs-loan fraud, check forgery and credit card scams.
Corporate fraud, generating nearly $500 billion in losses and comprising telemarketing, retail and cellular telephone fraud and other technology-related crimes.
Law enforcement agencies and corporate victims would make a mistake to attack these scams by industry, treating insurance fraud as separate from loan fraud or cell phone schemes, Mr. Vaules warned.
In fact, many scams are connected, as the same con artists typically move from one industry to another, switching, for example, from insurance fraud to cell phone scams, Mr. Vaules said.
Law enforcement may target one type of fraud, forcing those con artists to "expand into other areas," he said. "They are going to the target of least resistance."
"We don't think you should attack fraud by industry," Mr. Vaules said, noting that Trans Union has built a database with information on frauds broken down into about 200 categories that can be cross-referenced.
Phony insurance companies, several of which Mr. Vaules investigated as an undercover FBI agent, can be strikingly similar, partly because of the coaching that con artists give one another in operating the scams.
"It's a student/teacher arrangement, and a lot of the elements of the fraud will occur over and over again," he said.
"There are only 100 of these guys out there," he added, referring to practiced operators of bogus insurance companies. "If each law enforcement group would take one, we would put them out of business."
Policyholders concerned about a particular insurer should focus on the people running the company and their background, Mr. Vaules said. For example, he said, have they been named in civil suits for fraud or been involved in the past with failed companies?
"Don't worry about the name of the company. Worry about the people behind the company," he advised.
Also worry about the insurer's capital base, he added: "Without exception in the cases I worked, the fraud involved a phony financial statement" that included worthless or near-worthless assets, he said.
The con artists themselves also share some characteristics, Mr. Vaules added.
In researching cases handled by the FBI, agents found that large numbers of the targeted con men shared certain attributes that should serve as red flags to potential victims.
The FBI found, for example, that con men frequently: have been involved in failed real estate transactions; boast of unconfirmable international business connections; brag about unconfirmable abilities to raise venture capital; have only high school educations but claim to hold advanced degrees; produce resumes with gaps, unconfirmable prior employment or false entries; have civil judgments pending against them; frequently use post office boxes or mail drops; and cannot provide banking references other than basic depository relationships.
Mr. Vaules added that con men commonly lease cars, houses and apartments, preferring not to own assets that later could be attached by their victims in civil cases.
Even jail terms can amount to only a minor inconvenience to committed con artists, he suggested. In working undercover, Mr. Vaules said he completed fraudulent deals with convicted felons in the dayrooms of the prisons where they were serving their terms.
"Rehabilitation is not going on for these kinds of folks," he noted dryly.
In a separate presentation, Richard Marston, vice consul with the British Consulate in Miami, sharply criticized offshore jurisdictions that advertise themselves as tax havens while maintaining secrecy laws designed to conceal information about insurers based there.
Mr. Marston, formerly a white-collar crime investigator with Scotland Yard, was involved in cleaning up banking and insurance frauds in Montserrat and other British dependencies in the Caribbean.
While secrecy laws may be fine for personal business, "where it strays into the area of public trust or where it strays into the area of criminal activity, there should be no secrecy," he said.
Insurers and other companies operating as public trusts "should be entirely transparent," Mr. Marston said.
Banks must play a role in policing offshore clients, he added. He cited a case in which a Cayman Islands insurance company that received 30,000 premium checks in a single day deposited them in a local bank, transferred the money to a bank in Liechtenstein and converted it to certificates of deposit for the benefit of a family trust of the insurer's operator.
"It is the responsibility of a bank to know what a client company is doing with its money," Mr. Marston said.
Islands holding themselves out as tax havens also have a heightened duty to know where the money they attract is coming from and to guard against criminal activity. "Otherwise, you're going to attract every crook in Christendom to your jurisdiction," he warned.