Certain elements of a case will raise a red flag and trigger a Special Investigation Unit for plaintiff fraud. Let’s take a look what things will cause suspicion.
Non-Credible Medical Provider
Your Newport Beach personal injury law office will advise you to work with a reputable medial professional. Eyebrows go up if the treating physicians address is incorrect or the medical facility frequently changes names. A Newport Beach personal injury lawyer will also warn against bills that seem “off.” If bills are received for unnecessary procedures, fraud will be suspected. In addition, if a claimant says their doctor was referred to them by a “friend” without solid backup, insurance adjusters may be alerted to possible fraud.
While your Newport Beach personal injury law office wants you to receive the care you need, if the insurance company thinks the medical treatment is more than normal for an ailment, they’ll will likely be an investigation. Adjusters call this practice “build up” and it can trigger an investigation.
Frequent Referrals From Attorney to Doctors
If an insurance adjuster thinks there is a frequent routine between a Newport Beach personal injury law office and a primary treating doctor, suspicion can arise.
Out of Proportion Medical Expenses
Newport Beach personal injury law offices and the adjuster will be looking at medical expenses in relation to the property damage or vehicle damage. If there is very minimal damage to a vehicle, for example, but a huge medical expense, fraud will be suspected. If your car needed a $500 repair and you needed a $9,000 medical procedure, expect a Special Investigation Unit to be involved.
To get your questions answered, call Russell and Lazarus APC at 949-851-0222