The Department of Veterans Affairs clarified plans for deploying a data tool to assist staff in identifying suspected fraud in claims. The focus of the tool will be on third-party for-profit companies — known as claims sharks — that try to take advantage of veterans and the benefits system, the agency said. (Stars and Stripes)
WASHINGTON — The Department of Veterans Affairs announced Monday that it is dropping plans to scan 1 million old disability benefits questionnaires dating to 2010 to identify possible signs of fraud.
The VA, however, will still deploy a “data collection tool,” which is under development, to look for false or exaggerated medical evidence in newly submitted DBQs that are part of a veteran’s claim for benefits, the agency said.
“This tool is forward-looking only. VA will not use the tool to revisit previously finalized and…
Insurance fraud involves making false or exaggerated claims to an insurance provider.
- Hard Fraud: Someone deliberately causes a loss (e.g., setting fire to a warehouse or staging a car accident) specifically to collect a payout.
- Soft Fraud: More common and often viewed as “victimless” by the perpetrator. It involves exaggerating a legitimate claim, such as overstating the value of stolen items in a home burglary to cover the deductible.