Insurance Fraud

[Takeereasy]

This is the topic that makes me rail against humanity. I work for an appraisal company and most of our business is for the insurance industry. It seems that more and more everyone is trying to inflate their claims, or just making idiotic attempts to rip off the insurance companies. Yes I know they charge you too much for insurance. Yes I hate them too. But the thing I hate worse is thieves. If you try to steal from your insurance company the odds are you will get caught. I nailed some idiot kid today trying to claim for this awesome sound system in his truck. The claim was initially reported as a smashed window, then all of a sudden there was an additional claim for $2000 worth of stereo equipment and wiring. Of course the kid didn't have the stereo listed in his policy. Of course he didn't have receipts for 3/4 of the claimed equipment, but he had the boxes, and according to him that was enough. First off I received the report from the field appraiser and he tagged it as suspicious, and informed us that there was not any notation of anything except a factory stereo in the policy. I called the insured and spoke with them and informed them that the most they were eligible to receive for the stereo was $1000. They went berserk on me: f me, f my mom, f my company, then back to f me for a while. I calmly explained that since there was no coverage for an aftermarket stereo that there would be no possible payout above that policy limit. I also informed him that we had a few questions for him. We needed to know tiny things like how did the thieves steal the 6 by 9's out of the door panel without removing or damaging the speaker grills fixed into the door? Where did he mount the amp, since there was no evidence of an amp being mounted? How often did he drain his battery listening to 2 12" subs using an 800w amp, 2 8" speakers (that there again was no proof of mounting), and 2 6" by 9"s. How come he'd only wired his truck for half the speakers he was claiming? The question that made him hang up was when I asked him if he'd had a box built or made one himself for the 2 12" subs that he was claiming, but hadn't run wire for. His insurance company is pressing fraud charges and denying what I'm pretty certain was originally a legitimate broken window claim. I see this kind of crap and worse all the damn time. Most aren't stupid enough to catch in 30 seconds, but like I said the majority do get caught. Insurance fraud is rampant right now. I think it's because people feel that they are entitled to something extra for their premium. I pity adjusters for their jobs sometimes, and that's actually the job I'm being groomed for. I'm a nice guy, and empathetic, but I hate crooks. I look at my job now, and my impending one, as a beneficial one. I help people get the right amount of money from the insurance company. I'm good at my job and most times it's a great job to have. (and to be honest I love nailing crooks every once in a while)

On a side note if any of you out there have nice systems in your car please get them covered under your insurance, most insurers will only pay between $1000 and $1500 for an uninsured stereo, I've seen a guy with a $10,000 stereo get $1000, and then have his insurance policy cancelled for lack of disclosure. If you drive a $3000 car with a $3000 stereo in it then the car is worth $6000. If you don't disclose this to your insurer then you are only paying insurance for half of the value of the vehicle. Insurance companies hate that, and they can, and will, be petty in their punishment of you in the event of a claim. The same goes for home audio stuff, there are policy limits, and you should make sure you have sufficient coverage.

 

[Spiffyfast]

wow good info to know, back when I was in highschool I had a 93 Mustang GT with about a $3000 JL and Pheonix Gold sound system. Got a speeding ticket 115 in a 35 from drag racign so my inusrance went to almost 4000 per year. So i had to get rid of that car, picked up a geo prism for like 300 bucks and guess what, all my stereo equipment went into that car, didnt even think about an insurance claim problem. I'll have to remember that the next time I upgrade a stereo

 

[miklorsmith]

Good Advice

Great post and something I sure don't think about. Once you sign up for a policy, aside from paying the premiums, I don't think much about it. I should.

Thanks!

 

[Takeereasy]

Getting a seperate ryder for home stereo equipment is cheap too. The extra coverage is worth it. I pay an extra $45 a year and my HT is insured for $4000. I've been told that premium is going to double next year because of some new exclusions in my policy (one being my dog no longer counting as a security device, if you saw my dog you wouldn't break into my house, believe me she's the toughest looking wussy on the planet)

Also just to note you won't have to pay insurance for a $6000 car using my example above. The stereo stuff might increase the value of the vehicle, but there is generally a seperate section to fill out on an insurance application. Most likely for a $3000 system you'd be looking at like $50 to $100 a year depending on the company and the security system you have. Sorry to rant but I get so ticked after catching people trying to rip me off.

On a side note I'm pretty stoked about the following. I may get a chance to drive the following car:
2004 Maserati Coupe Cambiocorsa - Ferrari drive train, Red on tan leather, 4.2L engine - 390hp, Formula-1 Paddle Shift transmission, GPS navigation, heated seats, xenon lights, leather stitched headliner, 18 inch wheels, painted calipers, factory warranty, cd and cd changer, 8800 miles,

I've got pics of it. We're helping a wreckers sell it. That means most likely it's a stolen and recovered. Our company is tight with these guys and a couple of us are going to drive the 200 kl. to see this guy.

 

[MDS]

I've had a few insurance claims over the years and in my experience so far, most claims adjusters are pretty reasonable. I have never and will never claim that I had something that I didn't really have (I like to think I was raised better than that. )

The problem with insurance is having adequate documentation to substantiate ownership and that is where it can get tricky because few of us save every single receipt or take pictures of the entire house/car. But most adjusters will work with you to arrive at a value that is reasonably fair even if your documentation is slightly lacking - that's been my experience anyway.

It sure does sound like this guy was pulling a scam, but the biggest mistake certainly is to resort to profanity - you don't get anywhere with that approach. Just remember the old saying 'You catch more flies with honey than vinegar'. Be calm and respectful and the adjuster just may cut you a break.

 

[philh]

From the other side of the fence, I got nickled and dimed, and claused by the insurance company down to nothing.

Boat was damaged and had several items stolen, including ski, barefoot equipment, stereo, damaged IP in two places.

Ski and barefoot equipment not covered, because they weren't in a locked compartment
Stereo not covered, because it was over two years old... fine print
first damaged area, not covered because it was related to the stereo, which wasn't covered, and considered a seperate item from the second area
Second IP area, wasn't covered, because replacement parts were not available... another clause

This wasn't the cheapest coverage I could find, but it was a company that specialized in ski boats, and endorsed by the waterski association.

They also dragged their feet forever to turn everything down. While I may have been legally successful, by the time I got done with lawyer fees, it was cheaper to fix everything as best as possible and sell the boat, because the new one was coming very soon. Fully disclosed to the new purchaser, and it ended up only costing me a few hundred. He had looked at the boat before the damage / theft, and was still willing after, with a price adjustment.

I tried to be honest with the insurance company and got burned in the process. What incentive is there to not file inflated claims?

On the other hand, I had a claim on my home owners with some sewer back ups and they were more then fair. Essentially paid for a complete remodel job with me doing the work. They paid less then if a contractor fixed the damage, and I have a much nicer basement.

 

[annunaki]

According to the guys on 'Top Gear', the Coupe' Cambiocorsa is a weak contender in that market. In fact, they basically hated it. The handling was horrible, and they hated the cockpit.

In other words, do not expect too much.

 

[Takeereasy]

I love cutting people breaks. I love helping them. Nothing makes me feel better than knowing I'm making a bad situation at least a little better for someone. I am reasonable and easy to work with IMO. If you can show me just cause for something I'll go to bat for you. I have 2 complaints against me in over two years when most of my peers get that a month. Both complaints arose from situations that were far beyond my control and one of those involved fraud. I'm supposed to represent the insurance company but I don't get my check from them, and to be honest, it's easier to identify with the insured than the insurer. I have binding authority to settle claims up to $25000 for the insurance company that was involved in this claim earlier today. If this guy just had any explanations as to what was going on things might have been different. I heard just a while ago that now his story is that he had all the speakers in his car, but the weren't hooked up yet, they were just sitting there in the open. The insurer is attaching a claims investigator to this and have promised me they are going to go with criminal prosecution once the claim is denied in just a while. I doubt they do though, (despite what I said earlier)the fraud is only for a couple thousand. They'll just blacklist the guy and he'll have a hard time getting coverage.

PhilH, that sucks. I've seen it happen, and I'm never happy about it. A lot of it has to do with who the company has in the field appraising or adjusting for them. A good company should work with you and be willing to listen and always be available. Also a good insurance company is one that puts a ton of pressure on us to do our jobs quickly. Budget companies use staff that are essentially only there to get the experience and move on to a good company. They are overworked or lazy or both IMO. Good companies hire better adjusters and give them less claims to cover and more time to call and harass the people doing the work for them. That said I've been a part of claims where owners are unhappy with settlement offers. Usually because they have paid so much for something and don't realise that the second something is used it depreciates, generally very rapidly. It's a long drawn out topic that I'm on one side of the fence of. That said there is no exuse for bad service or slow payment from an insurer if all goes smoothly up to the final point. Boats are a tough nut to cover. We have 3 appraisers that are qualified out of our entire staff (really should only be 2).

As for incentive to not inflate a claim, criminal charges, voiding of home owners policy, denial of entire claim based on proven fraud or misrepresentation, massive, and I do mean massive rate hikes. How about decency and honesty? Also if you get nailed for filing a false claim you do get flagged. Insurance companies share info. Several banks own insurance companies or offer insurance. Banks control money. You like money. They don't like you. If you need a job think about this. If the insurance company files criminal charges against you and you get convicted then in your next job interview you will have to confess that you have been convicted of insurance fraud. That's a felony. Bye Bye job.

Again, I'm sorry you had such a crappy experience with your insurer. It should not happen. Period. I have my own insurance stories and I've never filed a claim in my life. I do have a GF with a lead foot though. Insurance in Ontario Canada right now is so insanely priced, and insurers are so tight on who they will insure, that most people won't report an accident. You wouldn't believe the number of new cars driving around with a thousand or two worth of damage. My brother in law from Texas was stunned.

 

[Takeereasy]

According to the guys on 'Top Gear', the Coupe' Cambiocorsa is a weak contender in that market. In fact, they basically hated it. The handling was horrible, and they hated the cockpit.

Annunaki, I drive a 97 Cavalier. Driving my buddy's 04 GMC pickup with the V6 is a hoot for me . I'm looking forward to this like you wouldn't believe. Paddle shiftin like a mo fo.

 

[Gatsby]

I'm going to be moving into another apartment and I want to insure my HT. I paid about 2500 for it, but I only have the sales slips for about $1100 worth. Is it possible to get coverage on the rest of it?

 

[goodman]

You really got me thinking. I'm going to take photos of my theater and also my living room and dining room. Then I'm going to call my insurance agent to make sure everything is adequately covered.
I have no love for insurance companies, but Takereasy is right, of course, that people try to rip them off all the time. I know of one guy who rode down to New York and parked his truck, and when he returned, it was gone and never recovered. Years later, I learned that the "theft" was prearranged, because he didn't want the truck any more, and wanted the insurance proceeds to pay off the note, which it did. Another guy wrecked his new sportbike. There was no collision coverage, but there was comprehensive coverage, so he dumped the wrecked bike in a ravine in the country, and then reported it stolen. Both of these guys got away with felonies, which is too bad.

 

[Mort Corey]

One thing to note is often times basic property coverage is on an "actual cash value" basis...ie, cost new minus depreciation. Guaranteed replacement cost is usually preferred (though at higher premiums) especially for higher value items such as electronics.

Mort

 

[Takeereasy]

Gatsby, take photos and talk to your broker. If you don't have a broker either get one or find out who your rep is with your company. A good broker will save you money and make sure you've got enough coverage. Just don't let them oversell you. You should have zero problems insuring for the amount you paid and make sure you get a replacement cost policy.

Mort Corey is 100% bang on when it comes to replacement cost versus actual cash values. This is so darn important. Whever possible/economically feasible try to attain replacement cost in a policy. In an auto policy you are required to carry it for the term of a lease. Some days my whole job is sitting at a computer and doing ACV studies. It's how the insurance company determines what your car or other property is worth. I can't count the number of people I've had to inform that the SUV they paid 40 grand for 3 and a half years ago, then drove the hell out of until they wrecked it, is only worth 14 or 15 thousand. The ones I feel worse for are the classic car restorers and mod car guys. If you spend $80,000 restoring a car to original condition that retails in pristine condition for $20,000 then guess what? It's worth $20,000. ACV's are based on what a maket will bear, and on what a "reasonable" person would pay.

That's it for insurance for me. I get to talk enough about it at work. My dream of driving a vehicle with a Ferrari power train is dead. I wont get to drive it so I'm not going to go two hours out of my way to look at it. Darn you cruel fate.

 

[Matt34]

I can't count the number of people I've had to inform that the SUV they paid 40 grand for 3 and a half years ago, then drove the hell out of until they wrecked it, is only worth 14 or 15 thousand.

Gap insurance

 

[corysmith01]

I've only filed a few claims in my life. Most went very smoothly, but one got me particularly steamed...in fact, I'm still steamed about it to this day.

I had my car broken into while in the parking garage at my apartment building. They stole my stereo (which I had on my claim) and the CD's out of my car. They agreed to cover my stereo, which was noted on my claim as a CD player, my subwoofer, amp, etc. HOWEVER, the refused to cover my CD's, which were in a sleeve that contained about 80 of them. If you do the math, 80 CD's at about $15 a pop totals about $1200 worth of music stolen. $1200 that they refused to cover. Why? Because, according to them, that's a home item and should not be in your car...my home owners/renters claim would have to handle it. Well, at the time, I did not have renters insurance, so I tried to fight....to no avail.

Why am I still mad? Well, they knew I had a CD player...they agreed to cover that in the settlement. So, doesn't it seem logical that if you have a CD player in your car, you need CD's? Their explanation was that since they are not necessary to the operation of the car and are, by definition home items, that they would not be covered. Well, number one, a car stereo is also not necessary to the operation of the car, and 2, CD's are not just used in the home?? They are used wherever there's a CD player. I just find it very odd...it felt like they were just trying to squirm. And me, not having renters insurance, was out a LOT of money in CD's. Their advice at the end of all of this; take your CD's to and from your car everytime you get in/get out of it. Yeah right...who does that?

To this day, I still haven't completely replaced every cd that was stolen.

And to this day, I still leave my CD's in my car.

 

[philh]

And to this day, I still leave my CD's in my car.

Copy the CD's and leave the copies in the car.

 

[corysmith01]

Copy the CD's and leave the copies in the car.

I'd love to, only my CD collection is about 300 strong...that'd take me days.

And by the way, I just noticed that things I typed above turned into hyperlinks...what the hell is up with that? Why are our forum posts not being turned into linked advertising?

 

[corysmith01]

AHHHHH!

And and ad for Blose no less!!!

 

[philh]

PhilH, that sucks. I've seen it happen, and I'm never happy about it. A lot of it has to do with who the company has in the field appraising or adjusting for them. A good company should work with you and be willing to listen and always be available. Also a good insurance company is one that puts a ton of pressure on us to do our jobs quickly.

The adjuster was great to work with. It was the company that was a PITA to deal with.

I understand exactly what you're saying about fraudalent claims, and based on my own personal integrity, couldn't, but sometimes...

I recently had to change homeowners insurance. When I had the problem in the past, they were fantastic. I gave them every opportunity, both through the agent and directly, to modify their quoted rate. I would have loved to stay with them, but they suddenly became way too expensive, maybe from being a little too fantastic? It was a substantial price difference, which I may regret some day in the future.

 

[Audioholics]

And by the way, I just noticed that things I typed above turned into hyperlinks...what the hell is up with that? Why are our forum posts now being turned into linked advertising?

This is one of the ways we make money so we can stay afloat. It's less intrusive than full page or inline ads and popups (which we refuse to do).

If you want more info you can roll over one and click on it where it tells you what it is.

And if you LOVE us - click on them, it pays the bills.