For detecting disability insurance fraud, training is key

August 29, 2018

Well trained insurance adjusters who are assessing disability claims should not only be able to spot impairment, but also potential fraud as well, notes David Nowell, PhD, a clinical staff member at UMass Medical School and an expert in independent medical evaluations as a practicing neuropsychologist.

Nowell is part of a team at UMass Medical School that provides disability evaluation training to insurers, nonprofits and government agencies.

"When I serve as a consultant I hear two different viewpoints regarding fraud: in some organizations fraud is a low concern because of a strong desire to connect people to benefits and services, while in others detecting symptom magnification is a major worry," said Nowell. 

Every organization that reviews disability claims should be interested in detecting fraudulent claims. The disability evaluation training conducted by UMass Medical teaches ways to spot fraud, including identifying symptom exaggeration, ensuring the validity of symptoms and checking exam performance. Knowing how to do that can help insurance adjusters spot when a claim doesn't hang together.

The Disability Evaluation Services team offers streamlined, high-quality, and cost-effective disability determination services government agencies and retirement boards seeking to improve their benefit eligibility services for individuals with disabilities.

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