The Very Best Fraudulent Insurance Claims

Michael Joyce really ought to know better.

The Pennsylvania judge was elected to enforce the law, not run roughshod over it.

Claiming injury, chronic pain and even brain damage, Joyce collected nearly half a million dollars from insurers after a 5 M.P.H fender bender.

After depositing the $390,000 from his insurer and an extra $50,000 from the other driver’s, he went golfing. And swimming. And inline skating. He even went scuba diving in the Caribbean and earned his pilot’s license. All with a brain injury and chronic pain. Right.

Well, the law caught up with this sleazy jurist, and if his appeal is denied, he’s looking at lengthy vacation in the clink (sorry, Mike, there will be no scuba).

The story of Michael Joyce comes courtesy of the Coalition Against Insurance Fraud, a collection of insurers, consumer advocacy groups and law enforcement organizations.

The group’s mission is three-pronged: lobby for tougher anti-fraud legislation; spread public awareness about the costs of fraud; and serve as a “clearinghouse” for fraud information and stories, such as the one about disgraced judge Michael Joyce.

(For similar stories, take a walk through the Insurance Fraud Hall of Shame.)

Insurance fraud comes in two kinds (hard and soft) and it goes in two directions (insurers defrauding consumers as well as consumers defrauding insurers).

Here’s an example of hard fraud, courtesy of the coalition:

Kenneth Allen led an arson ring that torched 50 homes and hauled in millions in bogus insurance claims, mostly in the Indianapolis and Muncie areas. Allen’s gang usually bought low-priced fixer-upper homes and loaded them with used furniture to inflate the claims.

Hard fraud is deliberate deception—usually faking injury or accident—in an attempt to collect money from an insurance company.

Insurance industry studies reveal that 10 percent or more of property/casualty insurance claims are fraudulent.

Soft fraud is another matter. According to the coalition, it encompasses “white lies,” convenient omissions and fact fudging. Shaving 30 pounds from your weight on your health insurance application. Underestimating your annual mileage. Harmless as they seem, these half-truths and mini-falsehoods add up. In fact, soft insurance fraud ends up costing insurers—and subsequently you and me—millions of dollars each year.

And that is why you should care about insurance fraud. Not because it will hurt insurance companies—they’ll be fine—but because fraud ends up raising your premiums. And that’s no laughing matter. 

NOTE: If you suspect that you’ve been defrauded by your insurer or agent, contact your state’s department of insurance.

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