How common is the practice of invoice fraud?

Specifically, billing for the more expensive glass while installing cheaper glass. Is this a widespread, common practice?

I know the readers on this board are not involved in any illegal activity--but it is going on. I have seen it with both large and small companies.

Comments?

i have heard rumors about networks billing for privacy parts, when the glass shop had installed non-privacy parts.

i have heard of a shop that waives deductables, and then charges for a tempered part and a w/s to cover the deductable; having gotten caught, but they are still in business. (i do not understand how that could be possible).

fraud cuts both ways, and intentional manipulation of pricing, with ficticious markey surveys is fraud as well.

i guess if your pockets are deep enough you can ignore laws though.

What do you mean by billing for more expensive glass?
Your beloved NAGS doesn't have a two prices for the same windshield number. (tinted vs. shaded may be different). If someone if installing tinted glass and billing for privacy I would hope they get caught, I guess I don't want to risk my reputation of 15 years to make a little extra. Is it fraud when TPA's lets a shop schedule work and then they sneek in before the appointment and do the job?

I don't think a glass company would know if this was going on, we don't know what the competition is billing out. The only people that would know if this was going on would be the insurance company. The question should be turned to you, what have you seen? The only fraud that I see in the glass industry are the practices of Safelite, if you ask how common their practice is I can honestly say daily.

I agree, nags does not have different pricing for "cheap vs premium glass". It used to be we didn't worry too much, about shopping our costs. we used to trust our suppliers that they were giving us the best "deal" our buying power would allow. Back then the profit margins were enough to not have to pinch every penny. I believe with todays market and pricing being controlled by the tpa's and ins co's it almost forces shops to price every little thing and pinch every penny possible to keep the doors open. Some net priced parts vary alot in cost between different distributors, but when we can buy better, and charge the same that's not fraud,, HAL,,, that's smart business. I think alot more fraud is happening from tpa's who charge the ins co's more than what they pay the shops. Also the most fraud happening is coming from sgc and lynx with steering, shorts pays & slow pays and thier scripts that are geared toward making it as difficult as possible for customers who choose to have thier work done by a non-network shop. There's your fraud hal.

As with any business, there are good people and bad people. I have heard of shops in my area billing for molding they don't use, creating fake shops so they get more network referalls, replacing windshields on windshields with surface chips, etc, etc, etc. They seem to generally be the smaller shops, but there are some bigger ones too.

That is the problem with the current excessive slide in pricing. The companies that do that kind of stuff are generally the ones that will do a job for $99 or $129 installed. You (the insurance companies) are getting ripped off by these companies and then trusting them to help you and the industry with pricing. It just doesn't work that way.

I think it wold be better if you built relationships with good shops, that have been around, have't had to file for bankruptcy, don't steal other shops business when they are supposed to be the TPA in the transaction and have proven to be honest and trustworthy. Instead, it's the opposite.

There are probably a handful of small shops putting in a tint and charging for a privacy glass. They could also be charging for moldings they don’t use. This is a negligent factor I’m sure in the overall picture. I would not be surprised if you looked at SGC’s or D/T billing practice you will probably find they include every billable part (moldings, clips, etc.) in their invoices on a nationwide basis. Whether they use them or not.
We are not privy to what the networks bill insurance companies on our behalf. I sure would like to know. Yes there are companies like 89Glass who advertise the illegal practice of not collecting deductibles. Not collecting a deductible is fraud.

pot - kettle

Hal, Country Companys will pay me for the Dealer windshield even though i installed the nags part number because they pay out less for the dealer glass in some cases. Even though i used the nags part #. Is this fraud? Also your current network will tell me to bill a dealer number when they dont have a price for a nags part so it will go through there system and not be rejected. As some of the other post have said you should look at your TPA you will be busy there for a while! I think its fraud when a insured goes years without a claim and then finally has one and yiu the insurance company raises there rates or drops them. Insurance companies have been know for deceiving and lying to there customers for years. Just look at the courts Insurance compaines are in court daily for poor behavior and unfair practices.

I just lost 3 jobs to safelite yesterday, I was trying to do a 3 way call, the person on safelites side kept telling us he/she could not hear the insured, I would then try to repeat the info and was told by safelite to stay out of the conversation, The customer heard the comment and asked what their problem was, funny, the safelite person only heard the customers name and the phone number, and got rude on the phone and said they need to call customer back with out me on the line, first one I said no, well, they did because they continued to say they could not hear, I even hung up on one and tried again, same story, well you guessed it, they called the customer back and talked them into going with safelite, Fraud? Hal, you need to get with the program, who are you trying to protect? I had a state auto claim about a month ago, customer was so up set with what safelite was saying they hung up, called the agent and told them to cancel the policy, agent called me back, we did the 3 way with safelite, agent was then up set with the way they were told they need customer on line, well, agent was able to retain customer but moved their policy to another co. I hope more will do that. ( oh they checked around to see what network did not have safelite )

Hal I sure am glad you started this thread! We had a customer the other day come in, sure was upset about sgc network. He told them more than once, more than twice, made it totally clear he wanted to use our shop, next day, a little red truck showed up and replaced his w/s in his driveway, which he did not want. He is an easy going guy and let them, he stated he will NOT be so nice in the future! I have a friend who last week bumped into a truck at the gas station, put small dent,maybe 200-300 damage, has not had any accidents or tickets whatever, his agent told him flat out,,, pay it out of pocket cause the ins co will raise your rates 15% for the next 3 years!!!! He is dumping them! Customer about 2 week ago broke out the back window of a convertable. Dealer only part, $934. list,, 5.2 hours labor per nags, sgc network, american family pricing, our bid 1500-1600. Am fam calls back , and 200 miles away, metro area some shop said they could do it for about 900. customer is still waiting to get this fixed and will probably need to take this to the state ins commish. Yes Hal FRAUD is going on daily but it is not the reputable shops commiting the fraud!!! Again, sure glad you asked the question.

THE BIGGEST LAWBREAKERS IN THE WORLD ARE INSURANCE COMPANIES. THEY DISCRIMINATE BY CHARGING MINORITES
WHO LIVE PREDOMINANTLY IN BIG CITIES MORE MONEY, AS WELL AS LOWBALLING THE UNEDUCATED ON THEIR CLAIMS.
JUST LOOK AT WHATS HAPPENING IN NEW ORLEANS. I TELL ANYONE WHO LISTENS TO TREAT THE INSURANCE COMPANIES LIKE THE DEVIL, BECAUSE THEY ARE THE SCOURGE OF THE WORLD AND ARE OUT TO SCREW YOU !! AS FAR AS HAL IS
CONCERNED, PROBABLY A GREAT GUY TO TOSS BACK A BEER
WITH, BUT HE IS SO BRAINWASHED THAT HE CAN'T BE TAKEN SERIOUSLY. UNFORTUNATELY, WITH WHAT HAL AND THE REST OF THE INSURANCE COMPANIES HAVE DONE TO OUR INDUSTRY
THERE WILL BE MANY MORE CASES OF FRAUD I AM SURE.

Remember the American Family thread a while back...they were found guilty of deliberately delaying and/or denying claims that were legitimate? They had a toy pig in their office. (We'll pay when pigs fly). I'd watch your own company Hal and let us worry about ourselves.

Hal, I think a better way of looking at it would be to allow a fair price for the glass. I do not know anyone that is padding bills except for the rumors surrounding that one big player.

But the cost we are allowed to bill today are 2% higher or in some cases less then two years ago. We are charged a fuel cost when we buy from PPG but, we are not allowed to bill LYNX or SGC a fuel charge.This A, B and C pricing is based on population and it is totally inadequate. If an installer in New York City is forced to bill “A” tier pricing how do you think he is going to compensate for his labor costs, rent, fuel charges? If anything bigger cities should be "C" tier not the reverse.

I think the fastest way eliminate your concerns is to allow the installers the ability to at lest keep up with inflation in our regions. Otherwise, I believe your little problem willbe a big one.

The only billing fraud going on is that the insurance companies and the networks are delaying payments, short paying, not paying for moldings, not paying for rust repair, not paying for fuel. If you want to talk about fraud why is that State Auto can short pay an invoice based upon Safelite's pricing. You want to talk about fraud look toward your TPA, they are the biggest culprits. Look at the fraud that Harmon Solutions created with their sales tax scam. You and your other ins. buddies seem to continually ignore the illegal activity that goes on with Safelite. Some day Hal you will realize what a mistake it was to use them as your tpa.

Thanks all for your responses. While I have not uncovered any improper activity on my TPA's part,
a confession [admission]and restitution check from a larger player prompted the question.

Your suggestion about invoice review does have merit, and we will implement such an audit program. That will give me an opportunity to speak with some of you as well.

Best holiday wishes for a safe 4th-

hal,

if you actually got a check returned with an admission, i would guess that is the tip of the iceberg. logically, they would admit to a smaller thing, in an effort to win your loyalty.

i would love to see you dig a little deeper, just to satisfy a little curiousity.

Hal, what was your point/intent with this string?

Straight answer, please.

Hal,

Here is my opinion on the billing fraud, the big player you refer to probably gives you a large discount to get the work, but the thing is you can't do the work for those kind of discounts and make a resonable profit, so what they do is charge for OEM or other parts to make up the difference. I know of a shop that does this. They give a large discount, then charge for OEM. I know this because I have had to redo a few jobs that they had done. When I asked the TPA what part were they billed for I was told an OEM number then when the car came into my shop an FYG or some other aftermarket POS was in the car. So it works like this give a big discount get all the work then have to charge for additonal parts or OEM parts to make a profit.

Hal,

I'll echo the previous post. I had a claims executive from a major company complain that they have one glass shop that bills for OEM on every job they do, even 15 year old pickups.

When I asked her why they pay it, she said that "we just do"

Stuff like this rewards the crooks and, in the long run, punishes the honest shops.

When will glass work become profitable enough so that people will not wish to take advantage of any opportuity to keep theyre failing businesses afloat ?

Thats the real question . Id not kill a man who stole a loaf of bread if he was hungry .

These TPA's and greedy insurance streamliners have all but taken the fun out of this "trade" if it can even be called that any longer give me a break .

wait a minute,,,,,i have tried billing for oem glass and got shot down both times.


what the heck is going on here?

i am obviously out of the loop somehow.

Joe, you are not alone, I have even faxed over a copy of my invoice showing that that part was the ONLY one in town, and the customer needed it done that day. Both shops that we called to get our glass told us that it would take a few days, one told me a week and a half, that is another issue lately, what is up with the common parts that Pilkington and PPg dont care but they can order it out from their Columbus warehouse charge me a fee and it will take a week to get it. But, I am still told they want to pay me less. So HAL, explain that would you. Hal, I would love to have you come audit my accounts so you would see just what a pain in the xxx it is to get paid and a fair price, PLEASE COME ON OVER!!!!

Invoice review and audit program?

Well, what's the TPA doing, and been doing?

And where is this information going to come from, Safelite?

So, the fox still guards the henhouse, right?

Hal, I'll believe your sincerity when your actions show unbiased results and ethics, but sorry, not till then.

To this point, your goals are simply self(company) motivated, not because they're the right thing to do.

i heard that these "Deductable waivers" will bill multiple parts, and that the customers go along with it to save there deductable.. I mean come on how the heck do you waive a $500 deductable otherwise??!?!?! thats insaine...

I have heard of some companies installing a windshield but billing for a back glass. But, it seems like the insurance companies would figure out pretty quick that certain companies have an unusally high number of back glass installs.