Often, when insurance companies deny claims, they do it under the pretext of asserting that some element of the policyholder's story puts the validity of the claim into question. In most cases, this is nothing more than the insurance company trying to save money by delaying or denying valid claims.
However, it is important to recognize that insurance fraud is a real problem, and that fraudulent claims hurt everybody by driving up costs and giving insurance companies all the more justification for treating valid claims with skepticism.
In the past, Florida has tended to have a bigger problem with insurance fraud than other states. New data on the subject doesn't give much hope of progress, either. According to a recent report from the National Insurance Crime Bureau, the number of "questionable" insurance claims in Florida went up by more than 22 percent between 2010 and 2012. All told, there were nearly 10,700 questionable insurance claims in the state in 2012.
Almost half of the questionable claims came from three South Florida counties: Miami-Dade, Palm Beach and Broward. Of those, approximately 48.5 percent were suspicious personal injury protection (PIP) auto insurance claims.
PIP fraud is a known problem in Florida. Lawmakers have been working on reforms to the system, but their efforts have been met with some resistance.
The fact that insurance fraud exists is no excuse for insurance companies to deny otherwise valid claims. Insurance is a contract, and policyholders with legitimate claims deserve to get the benefits they have paid for.
Source: The News-Press, "Questionable insurance claims increase in Florida," March 14, 2013.
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