Forensic Accounting Experts Analyze and Report on Insurance Claims

Reliable litigation support for defense and indemnification of policyholders

An insurance policy is a contract to defend or indemnify an organization who has suffered an insurable loss. Both of those actions come at a cost, and insurers must be careful to only pay as much as the facts warrant. Yet, the danger of overpaying and even being taken by a fraudulent claim is pervasive. How then can the insurer protect its bottom line without abrogating its responsibility? North American Forensic Accounting is ready to support your claim dispute with expertise acquired over decades of investigative work. At NAFA, our forensic accounting experts have decades of experience analyzing insurance claims and serving as expert witnesses in contentious, high-value litigation. Working closely with legal teams, we assist in discovery, suggesting the lines of inquiry attorneys should pursue and what documentation they should demand. We prepare concise reports in plain language that an arbiter, judge, or jury can readily understand. Additionally, credible testimony from a forensic accountant can make a difference in the outcome of any insurance dispute. If called to testify, our expert witnesses present the evidence in an orderly, methodical fashion, supporting the narrative that legal counsel is constructing for the case.

Detailed loss calculations for a variety of insurance claims

NAFA’s forensic investigators are prepared to assist in a wide range of insurance claim cases, including:

  • Business interruption
  • Disability income
  • Fidelity insurance
  • Property and casualty
  • Liability
  • Medical malpractice
  • Professional malpractice
  • Personal injury and wrongful death
  • Employment discrimination and wrongful termination

Our team is adept at calculating all categories of economic losses, such as:

  • Lost profits
  • Delay in startup
  • Lost inventory
  • Property damage
  • Medical bills, present and future
  • Lost income/wages, present and future
  • Reputational loss and brand damage
  • Consumer privacy liability

Whether your company is called on to indemnify or defend a policyholder, you need rock solid data on losses as a starting point for your negotiations. NAFA can perform detailed analyses to arrive at a firm figure. You can trust our reporting, not just because of our decades of experience, but because we present the facts in an easily comprehensible fashion, so they are ready to present to opposing counsel or to a judge and jury.

Thorough investigations to assess potential losses and prevent overpayment

The Coalition Against Insurance Fraud estimates that fraud in insurance claims wastes about $308.6 billion every year in the United States. They also figure that fraud exists in roughly 10 percent of all property casualty insurance claims. Insurance fraud drives up the costs for consumers, who then must cut back on coverage. That’s less revenue for your company and lower satisfaction for your customers, who might find out later their deductible is too high or certain losses just aren’t covered. To control costs, service your policyholders effectively, and grow your business, you need to effectively evaluate claims. North American Forensic Accounting can help you investigate a range of claims to ensure their validity. Our team is comprised of experts in forensic accounting, who can get to the bottom of any disputed claim.

Skilled forensic accountants examine insurance claims for fraud

As certified antifraud specialists, we know how to spot patterns of behavior that indicate active fraud schemes. By examining company records, we can pinpoint exactly where fraud has occurred. We assemble the evidence necessary to expose the scheme and enable you to take decisive action.

When an individual claim is suspicious, we pore over the records to evaluate the alleged losses. Most often, insurers retain us to calculate business interruption claims or refute claims that seem excessive in light of past performance. For example, policyholders will often claim more losses than they can justify by citing peak months’ revenues, rather than their expected off-season earnings, and failing to adjust for other external factors, such as a slowdown in the overall economy. They might exaggerate expenses to ramp up operations after the stoppage, including repairs and restocking. Some claimants also wildly exaggerate losses due to damaged inventory. A close examination of the business records might show they never had as much stock on hand as they are now claiming they lost. If something is amiss, you can trust NAFA to bring discrepancies to light and let the true numbers tell their story.

Contact North American Forensic Accounting to uncover and prevent insurance fraud

North American Forensic Accounting helps insurance companies detect ongoing fraud schemes and evaluate the merit of individuals’ claims. NAFA serves clients from offices throughout the United States, including in Philadelphia, Pittsburgh, New York City, Atlanta, Charlotte, Miami, and the Tampa Bay Area. Call us at 347-286-4860 or contact one of our offices online to schedule an appointment.