Posted on Sat, Nov. 27, 2004


Legislature needs to tackle growing insurance fraud



ACROSS SOUTH Carolina, there are people preying on unsuspecting individuals and businesses by selling bogus insurance policies. There are people staging wrecks and other claims in order to collect insurance payments to which they are not entitled. There are individuals and companies lying about everything from the number of miles they drive to work to how dangerous the workplace is, in order to pay lower rates.

The insurance industry estimates that the average U.S. family pays an extra $1,030 in insurance premiums each year to cover the cost of medical, auto and life insurance fraud. And, as The Post and Courier of Charleston recently discovered, insurance executives and state officials worry that South Carolina is becoming a magnet for insurance scammers, driving costs even higher.

Fraud complaints have grown by 61 percent, to 844, in the past five years. But the number of state employees combating fraud has plummeted, from 20 down to two SLED agents, one prosecutor and one assistant.

The problem isn’t just that the insurance fraud division in the attorney general’s office has taken an even bigger budget hit than most of state government; it’s also that we didn’t have an effective deterrent even when we hired enough people to enforce the law.

“If you were picking a state to run scams from, why wouldn’t you pick South Carolina?” one insurance official asked the newspaper. “If the penalties aren’t tough enough, the prosecutors and law enforcement agents are understaffed, then that is the state you’ll go to.”

Currently, we spend about 7 cents per person fighting fraud in South Carolina. Even if we decided to raise taxes or assessments on insurance policies to pay for stepped-up enforcement, it would be money well spent, given how much fraud costs us all. But no one is seriously proposing to make consumers foot the entire bill.

A proposal put forward last year, with the blessing of Attorney General Henry McMaster and officials with the state Insurance Department, would increase the assessments on insurance policies, to raise $2.5 million to create a new civil fraud division in the Insurance Department. But it also would increase the financial penalties and prison time for fraud, so they would be more in line with other states — some of which pay for their entire enforcement effort with the fines they collect from scammers.

It is not only appropriate but also important, in terms of reducing fraud, to make those who break the law pay for the enforcement; the reason to fine and imprison people for breaking the law is not just to punish them, but to deter others from breaking the law.

Unfortunately, infighting in the insurance industry over how the assessments would be levied stalled the legislation. A similar move next year needs to overcome the infighting.

Insurance is different from other products and services, because the state requires most individuals and businesses to purchase some type of insurance, such as automobile insurance or workers’ compensation insurance. Since we have no choice but to purchase it, it’s not unlike a tax. And so the government has the same sort of obligation to police the insurance industry as it has to make sure that tax collectors aren’t shaking down people and tax money is being spent appropriately. In recent years, South Carolina’s government hasn’t been meeting that obligation. It’s time for that to change.





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