Nebraska Department of Insurance

NEBRASKA DEPARTMENT OF INSURANCE INSURANCE FRAUD PREVENTION DIVISION 941 O Street, Suite 400 Lincoln, NE 68508-3639

Commercial Fraud Hints

It is important to remember that the hints listed below are merely possible "red flags" that there may be some evidence consistent with an insurance fraud scheme.  Any one or two of these by themselves, may not raise your suspicion; however, when you have several of these hints present or a pattern begins to emerge, you should investigate further or forward your suspicion to the Insurance Fraud Prevention Division.

1. The claimant is approaching retirement age.
2. The claimant would like to retire.
3. The claimant is ill.
4. The claimant's financial obligations are in arrears, such as taxes, payrolls, and loans.
5. The claimant had a renovation loan approved before the loss, but work had not begun.
6. The property is in receivership or foreclosure.
7. A required technology change would require a major investment.
8. The mortgage is held by a private entity.
9. There is a claim for rental income, but no occupancy documents.
10. Property was removed from premises prior to the loss.
11. A lack of debris after the loss perhaps suggesting that the building was stripped.
12. All documentation was allegedly destroyed during the loss.
13. A claim for theft is filed but no evidence of forcible entry.
14. The loss occurred on a holiday, weekend or after hours.
15. The fire alarm or sprinkler system did not function.
16. Fire doors were left open.
17. Work orders were canceled just prior to the loss.
18. The business is not meeting production quotas or deadlines.
19. The business' inventory is obsolete or overstated.
20. The business' storage area is too small for the amount of claimed inventory.
21. The business inventory includes seasonal inventory or equipment.
22. The unit value of items is overstated on the inventory.
23. Receipts were unnumbered or on generic forms.
24. Receipts included pre-printed information.
25. Invoice quantities and/or costs were inflated.
26. Invoices reveal a large purchase with past vendor/claimant relationship.
27. Claimed loss not directly related to claimant's business.