Knocking Down The Door Of Fraud: How To Pursue Affirmative Litigation, And Knowing When To Change Course

Investigating and litigating singular fraud cases for first- and third-party claims used to be the mainstay of special investigation units.

While these tactics can be relatively successful, there is still a whole world of abuse and misrepresentation stemming from medical providers, durable medical equipment suppliers, diagnostics entities, premium fraudsters, auto body shops, copy service providers, and more.

A newer, cost-effective way to deal with fraud is affirmative litigation.

Think of fighting fraud from both a defensive and offensive posture. This is an exciting avenue and requires, first and foremost, agreement and support from leadership to undertake this process.

It often has a long investigative tail and has associated legal costs, but the benefits are far-reaching and can prove to be extremely beneficial to the carrier, resulting in deterrence, punishment of the wrongdoers, and financial recovery.