Nebraska Department of Insurance

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

Doctor/Lawyer Collusion 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. Attorney's representation letter is dated same day as accident/injury or shortly thereafter.
2. Insured/claimant initially contacts the insurer to settle and never mentions injuries, then later obtains legal representation and develops diagnosed injuries.
3. Unrelated occupants of the same vehicle go to the same lawyer and medical provider, particularly when all have the same injuries and receive the same treatments on the same days.
4. Attorney sends all occupants to same medical provider regardless of the injuries.
5. Same attorneys and medical providers handle high medical and lost earning claims following minor physical damage accidents.
6. Attorneys and medical providers representing claimants have been involved in prior suspicious or fraudulent claims.
7. Medical provider was referred to insured/claimant by attorney or vice versa.
8. Attorney does not provide claims representative with itemized bill identifying diagnosis, procedures, treatment modality, even after numerous requests.
9. Attorney refuses to allow claimant to sign medical authorization to allow collection of medical record information directly from medical provider.