The insured submitted a PIP claim on a personal auto policy. She claimed significant injuries, though the contact between the two vehicles was limited at best. She even claimed that she needed help bathing and getting dressed.
An investigator met with the insured, who admitted that her daughter’s car was in her garage, though she said her daughter moved out just before the policy inception. The car was not disclosed on the policy application. Strike 1. The insured claimed wage loss from her full-time self-employment job making deliveries for Instacart. She had been doing the Instacart work for a year, but had a personal lines policy. What she didn’t know is a personal auto policy doesn’t cover her vehicle for a full-time delivery business. Strikes 2 and 3. Claim denied, saving the insurer $50,000.
Finder.com estimates that 35.8 million American adults admit to lying on their auto policy applications regarding residency, who drives what, where, for what and their driving history. NerdWallet’s study estimates this to be a $29 billion dollar loss, before the COVID-19-induced delivery boom.
“Lying on a cell phone app or failing to check the appropriate boxes on a piece of paper is one thing, but lying while face-to-face with a person is different,” says Bill Randall, vice president of Investigation Solutions. He reminds his investigators, “Ask a direct question; insist on a direct answer. Don’t let them avoid answering the question by taking the conversation in another direction. Almost all will tell the truth vs. a lie if we insist on a direct answer.”