Smoke, Fire, and False Claims: How Forensic Accounting Uncovers Insurance Fraud
Uncovering the Truth. Protecting Your Interests.
Insurance fraud costs billions each year. Whether you’re an insurer, attorney, or policyholder, uncovering fraudulent activity requires expertise, precision, and discretion. At North American Forensic Accounting (NAFA), our team can provide the investigative insight and analytical power to detect, quantify, document, and deter insurance fraud.
In one recent instance the NAFA team was brought in by an insurance company to review a business interruption (BI) claim brought by an independent pharmacy whose business was impacted by a fire. The insurance company was suspicious of the amount being claimed and asked NAFA to examine the claim. Upon examining the numbers, the NAFA team quickly concluded the numbers made no sense. Further review made it clear that the BI claim was highly inflated. The result – significant savings for the insurance company and ultimately prosecution of the fraudsters.
Our Expertise in Insurance Fraud investigations.
Claims Validation – We can analyze financial records, invoices, and supporting documentation to assess the accuracy and legitimacy of insurance claims. We then can detect patterns of inflation, misrepresentation, and fabrication.
Litigation Support & Expert Testimony – Our credentialed experts present complex financial findings in court-ready reports and offer authoritative testimony to support legal proceedings.
Financial Loss Reconstruction– We can quantify actual economic losses through detailed reconstruction of books, ledgers, and revenue streams—helping distinguish between legitimate and fraudulent losses.
Internal Fraud Risk Reviews– We can help insurers and large policyholders evaluate internal controls and implement measures to reduce exposure to fraud.
We specialize in identifying fraud schemes across a wide spectrum of Industries from insurance, banking, healthcare to auto and property claims and more.
Why Choose Us?
NAFA employs Certified Fraud Examiners (CFE’s), CPAs, experienced investigators and business subject matter experts and can assemble a highly qualified team tailored to your engagement. NAFA has both the requisite expertise and experience in Insurance fraud investigations.
NAFA employs Court-tested methodologies and reporting standards and conducts discreet, efficient investigations with clear deliverables.
Protect Your Claims Process. Partner with North American Forensic accounting to identify and quantify fraud, mitigate exposure, and help ensure integrity across the insurance system.