An ACM claim adjuster handled a bodily injury claim at the California/Mexico border, on a National Unity policy. The insured admitted fault, stating that she accidently struck a pedestrian that was standing behind her car. The claimant said she was walking in the parking lot. She was looking at her cell phone when the insured… Read More
Stories
Home “intruder” was actually a boyfriend
A homeowner reported waking in the middle of the night to an intruder. A fight ensued and the intruder fled with over $6,000 in personal property, breaking two windows. The insured acknowledged recognizing the suspect as a prior renter. The suspicious incident was referred to IS as a possible case of homeowner policy fraud. Investigators… Read More
Stolen good weren’t stolen. Claim closed.
An ACM adjuster was assigned a GL claim for a claimant who said her car and personal property were stolen when she dropped her BMW off at our insured dealership. Her investigation verified that someone stole the vehicle, which was recovered the next day. Another customer was arrested for the theft. The claimant was paid… Read More
Purchasing a policy AFTER the accident doesn’t count
The insured called to report that she was in a car accident. The claims adjuster couldn’t reach the insured by phone. Noting that the date of loss was the same as the date of policy inception, the adjuster referred the case to IS. When the investigator interviewed the insured, she said she thought she hit… Read More
ISI obtains conviction in work comp fraud case, saving client $150,000
Working on behalf of our carrier client, we filed a work comp fraud case with the District Attorney, obtaining a conviction of a former employee hired as a driver. The driver filed a fraudulent claim after he was terminated. He was found guilty of insurance fraud and ordered to pay more than $84,000 in restitution. The… Read More
Work Comp Fraud: Hell hath no fury…
A day laborer reported back and neck injuries after falling 10 feet off a water tank, landing on his back. Sometime later, the claimant’s ex-girlfriend called his then-employer, wanting to testify that he had not been injured and his claim was fraudulent. The ex-girlfriend also said that he was currently working and did not appear… Read More