South Carolina cracks down on insurance fraud

From Greenville Online
By Julie Howle
STAFF WRITER

It could be a false claim, an overstatement of damages and injuries from an accident or not reporting accurate medical history when applying for health insurance.

But whatever the form, insurance fraud is one reason South Carolinians are seeing a larger portion of their paychecks go to rising insurance costs, said Trey Walker, a spokesman for the State Attorney General's Office, where the budget has been boosted to chase offenders.

Walker said that as insurance companies lose money because of fraud, the cost is passed on to the consumer. He said the average American household pays about $1,000 a year in out-of-pocket costs as a result of insurance fraud.

The office sees cases every day, he said, like the Travelers Rest man who pleaded guilty to insurance fraud recently and got a five-year suspended sentence and three years' probation in a case where prosecutors said he claimed the same damage to his pickup truck twice. He was ordered to pay restitution of $3,899.72 to State Farm Insurance Co.

James Quiggle, a spokesman for the Coalition Against Insurance Fraud, said there is $80 billion in insurance fraud each year nationally.

He said insurance fraud can range from people underreporting the number of miles they drive on their auto policy to staging an accident and having passengers pretend to be injured to collect insurance.

And there's always an influx of fraud after disasters as well, whether it is a flood, ice storm or hurricane, he said.

"People will always swoop in and try to profit from a natural disaster," Quiggle said.

Fraud doesn't just hit insurance companies, according to the Coalition Against Insurance Fraud. People can lose their life savings because of insurance investment schemes, pointing to swindlers who sell nonexistent health policies or other insurance plans, the group said.

The state Attorney General's Office has been prosecuting insurance fraud by statute since the mid-'90s, and the office has a division devoted solely to insurance fraud prosecution, Walker said.

Walker said that initially in the mid-'90s the office had two prosecutors and two State Law Enforcement Division agents dedicated to prosecuting insurance fraud across the state.

But with budget cuts, the office shrank to only one prosecutor and two SLED agents, he said, which led to a tremendous backlog that the offices are still working through today.

Walker said the Legislature acted to provide an additional $400,000 a year to the Attorney General's Office to hire insurance fraud prosecutors, starting in fiscal year 2005-2006.

In July 2005, the office hired four more prosecutors and now has five prosecutors devoted to insurance fraud cases.

Walker said in the first quarter of the 2005 fiscal year, the office had a 250 percent increase in the number of insurance fraud cases it handled and closed compared to the first quarter of the 2004 fiscal year.

More tax money is going to the state Attorney General's Office to pursue insurance fraud cases. It's a crime that contributes to higher insurance costs, and prosecution could diminish the extent of the problem.