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The Fraud Next Door... IS YOU
Do you bill insurance
companies for the treatment of
patients injured in auto accidents?
Did you know you are a fraud?
Andy Baratta, Attorney at Law Baratta, Russell & Baratta
{Editor’s Note: This article is the first of a two-part series. Please see the February/March 2018 issue of Plexus for Mr. Baratta’s concluding entry.} Inventing Fraud for Profit
In the 1990’s, global consulting giant McKinsey & Company revolutionized the way auto insurance companies handled bodily injury claims by showing them how they could use their claims operations as profit generators.
McKinsey identified that of the tens of thousands of bodily injury claims being made daily across the country as the result of auto accidents, the largest majority could be classified as “Minor Impact, Soft Tissue” (MIST) injury claims. Because these claims involve relatively minor property damage and mostly subjective injuries, McKinsey advised that insurers could dramatically drive down the costs of these claims simply by handling them all as fraudulent.
Over the past two decades, the entire insurance industry has adopted varying versions of McKinsey’s “fraud funnel” to reduce claims payments by billions of dollars every year. The idea is simple: invent a new definition of fraud which enables the accusation to be made in virtually any claim. This was accomplished with the invention of “fraud indicators.”
There are now hundreds and hundreds of “fraud indicators” which insurers apply to every kind of claim in order to feed the fraud funnel. Most relevant and alarming to chiropractors, though, should be the fact that treatment with a chiropractor is a fraud indicator in any bodily injury claim.
Most relevant and alarming to chiropractors, though, should be the fact that treatment with a chiropractor is a fraud indicator in any bodily injury claim.