The insured claimed he was held up by gunpoint at his business. He claimed he was hogtied and pistol-whipped; then the suspects stole four vehicles from his auto repair shop, including one of his personal vehicles. He did not call the police to respond to his business but drove himself to a local police station to file a report. When the claim was filed, he added several items of significant value reportedly taken by the suspects that were not listed on the police report and were added as a supplement.
The file was referred to SIU to verify that the items being claimed stolen were consistent with the facts of loss and police report.
The investigation identified certain inconsistencies in the insured statement of loss. He failed to provide documentation or a supplemental police report listing property loss inventory.
The background investigation revealed that the insured is a convicted felon with an extensive criminal history and had recently been charged as a felon in possession of and brandishing a firearm. We found that at the time of the incident, the insured had a number of financial issues including breaking up with a long-term partner for his business, eviction from the business location, being involved in a divorce from his spouse, and being under IRS audit with respect to tax issues. The insured also had a former association with one of the potential suspects which involved criminal activity.
The insured’s statement was obtained, and he advised that he also was going to file a claim for Business Interruption.
The insured failed to cooperate with the investigation and provide requested documents, after being given repeated opportunities to do so. Based on the lack of cooperation, the examiner closed the claim.
As result of the quick identification of the suspect nature of the claim, we were able to save the carrier approximately $25,000.