Adjusters discuss why aggressive roofing estimates keep claims open longer and how inconsistency fuels disputes.

Heavy investment in insurance AI continues to deliver limited returns as automation accelerates workflows without improving decision quality, explainability, or claims outcomes.

A new statute regulating consumer litigation funding and a key appellate ruling expanding discovery reshape fraud defenses and transparency in New York claims.

Appeals court says fraud claims may rely on public records without violating California’s public disclosure bar.

Frozen pipes, kitchen fires, icy walkways, and parking lot crashes make winter the busiest season for property and auto insurance claims. Here’s how adjusters can prepare.

Courts require more than a positive THC test to prove workplace marijuana impairment. Here’s what claims adjusters need to know post-AB 2188.

A California officer faked a disabling injury while collecting benefits, only to be caught performing manual labor on his property. The case underscores the vigilance required in high-risk workers’ comp claims.

A total loss rep allegedly issued over 100 fraudulent checks in a scheme spanning multiple counties. Investigators detail how internal access was exploited.

The lawsuit aims to seize phishing infrastructure blamed for millions of fraudulent texts and widespread financial losses affecting U.S. consumers and insurers.

As cyber and AI regulation expands, insurers and panel providers face increased claim costs and demand for specialized expertise next year.

Insurer accuses two Brooklyn-based suppliers of billing for unnecessary and undelivered medical equipment through a kickback-fueled fraud scheme. The lawsuit seeks to block $2M in pending no-fault claims.

State investigators and Farm Bureau staged a bait house to catch a roofing contractor fabricating wind and hail damage in an alleged insurance fraud attempt.

The Hartford’s analysis of 1 million small-business policies shows rising costs for fire, injury, and water damage claims, with risk mitigation strategies gaining traction.

Semantic ontologies and AI-powered validation tools are transforming how insurers clean and structure their data, improving underwriting, fraud detection, and claims accuracy.

SAS forecasts AI’s shift from auxiliary tool to operational core, reshaping claims, underwriting, and fraud detection as insurers face mounting climate, economic, and regulatory pressure.