The claimant reported that a sewing machine and an embroidery machine were stolen from his parked and locked vehicle. He reported the loss on the day it allegedly occurred under his homeowner insurance policy. He submitted a property inventory that reflected their value at approximately $30,000. We were asked to complete an investigation and we… Read More
Stories
Was there really smoke and ash – or was it smoke and mirrors?
This homeowners’ claim involved loss from alleged smoke and ash damage from a wildfire. The loss was reported by a California public adjuster in March this year; their notice of loss referenced an unspecified wildfire event in June 2022 and bears a digital signature of the insured. We interviewed the insured who recalled receiving a… Read More
“Cumulative trauma” didn’t stop this guy
The “injured” worker claimed a cumulative trauma work injury to his shoulder and leg, doing construction work. Lots of subjective complaints, without objective findings. He was missing physical therapy appointments. He had an attorney, so a face-to-face discussion about his recovery was not an option. The employer suspected he was working elsewhere. Time for surveillance…. Read More
What happens when a work comp claim isn’t filed
An electrician was injured at work. He needed surgery and could not work. Accidents happen – that’s why employers have workers’ compensation insurance…or not. The employer tried to provide benefits directly. The claimant hired an attorney. The case came to our sister company, American Claims Management (ACM) late, preventing their claims and medical staff from… Read More
Injured ambulance worker NOT injured
One of our adjusters received a claim from a part-time hospital respiratory therapist of injuries to the shoulders from lifting patients. The claimant was paid lost wages for two years. The PQME gave the claimant a 10-pound lifting limit. In his deposition, the claimant testified that he could not, and had not, lifted more than… Read More
Major bodily injury claimed when car was going less than 2 mph?
Two years ago, an adjuster was assigned an auto injury claim involving one of our insured’s ambulances. Nothing like large commercial policy limits to whet an attorney’s appetite. Our driver admitted fault, actually offering to pay for the damage himself. It seems our ambulance caused a little damage – $530 worth – to the Prius…. Read More