2025 Report Highlights Online Insurance Fraud in Disability, Workers Comp, and Auto Claims
The recent 2025 Online Fraud Insights report by Carpe Data highlights significant findings on insurance fraud across various lines, with disability, workers’ compensation, and auto insurance showing the highest rates of contradictory evidence indicative of fraud. Specifically, 8.9% of disability claims, 6.9% of workers’ compensation claims, and 5.7% of auto claims featured misrepresentations. The report underscores that most fraudulent activity is detected through online channels, predominantly social media platforms such as Facebook, Instagram, LinkedIn, TikTok, and X, where claimants often post content inconsistent with their claims.
Carpe Data's analysis revealed that 82.7% of the detected fraud was identified on social media, with Facebook providing the largest pool of red flags. Claimants frequently post about activities like travel or workouts that conflict with their injury claims, enabling insurers to detect inconsistencies early in the claim lifecycle. Notably, about 35% of fraud referrals occur within the first two months of claims being filed, suggesting that early online monitoring can enhance fraud detection efficiency.
Demographic trends point to younger claimants, particularly those aged 18-24, as more prone to submitting fraudulent claims. This group's higher likelihood of triggering flags related to physical activity or illicit behaviors is attributed to riskier behavior patterns and a tendency to overshare on social media platforms.
The geographic analysis within the report associates elevated fraud risk with urban areas that have robust legal infrastructures, dense populations, substantial tourism, and economic challenges. These conditions, combined with legal loopholes, especially in workers’ compensation laws, create fertile ground for insurance fraud schemes. Attorney involvement and organized urban fraud rings further exacerbate these issues in certain cities.
Overall, the report emphasizes the critical role of integrating digital intelligence—monitoring social media, local news, and public records—into claims management processes to identify contradictory evidence swiftly. This approach supports strategic deployment of investigative resources, helping insurers mitigate fraud losses effectively in a complex and evolving risk landscape.