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When an Insurance Claims Adjuster Will Suspect Fraud


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5/8/2014
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Clients of an attorney at a Baltimore personal injury law firm often ask about medical credibility if the insurer suspects fraud.Baltimore personal injury law firm

A Baltimore Personal Injury Attorney Will Explain When a Adjuster Might Suspect Fraud

  1. A discrepancy between what is in the medical records and what the claimant says happened in the accident. If the victim said one thing when discussing the injuries with a medical professional and another when describing the injuries with the adjuster, the adjuster might believe that the claimant is altering the facts to suit the case;
  2. Treatment that doesn't suit the injuries the claimant states he or she suffered. If a medical professional made certain statements in the medical report and the treatment the claimant was given is not consistent with the injuries, it will warrant further investigation. If a claimant suddenly has complaints of new injuries requiring more treatment, it could be a signal that they're trying to increase the damages and receive more compensation;
  3. Physical inconsistencies when claiming disability. If, for example, the claimant appears to be in good shape and shows evidence of having performed work involving physical labor but simultaneously states that he or she is unable to work due to their injuries, adjusters will wonder about the claim; and
  4. Bills and medical records that do not appear consistent or accurate. If the records appear to be copies or were part of a template, this too will be thought of as being evidence of potential fraud. Some doctors are known to insurance companies as friendly to personal injury claims and if they're part of the case, adjusters will examine the case more closely.


Contact an Experienced Baltimore Personal Injury Attorney
If you have questions about when an adjuster will suspect fraud in a case, an attorney from a Baltimore personal injury law firm can help. Call the Law Offices of James Lee Katz, P.A. at 443-394-0900 or 800-564-7808 today. 



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