Fraud Friday

Three guys are fishing in the Caribbean. One guy says, "I had a terrible fire; lost everything. Now the insurance company is paying for everything and that's why I'm here."

The second guy says, "I had a terrible explosion; lost everything. Now the insurance company is paying for everything and that's why I'm here."

The third guy says, "What a coincidence. I had a terrible flood; lost everything. Now the insurance company is paying for everything and that's why I'm here."

The other guys turned to him with confusion and asked, "Flood? How do you start a flood?"

Fraud Friday

People will go to ANY LENGTH at times to get an insurance claim. THIS might not be the best way.

Watch video here.

Fraud Friday

From Prada to Prison: the Story of a Wannabe ‘Real Housewife’

A woman who wanted to become part of the “Real Housewives of Orange County” cast is going to get a different dose of reality as she was recently sentenced to 10 years of probation on November 30th. She was convicted for committing a state record of over $30 million in workers’ compensation insurance fraud.

Read Full Story Here

Fraud Friday

The statements below are taken from actual insurance accident claims forms. They are real, true (you can't make up this kind of stuff). Read 'em and laugh and be glad it wasn't you. Read full article here.

Incidents with Pedestrians.

• The pedestrian ran for the pavement, but I got him.
• The guy was all over the road. I had to swerve a number of times before I hit him.
• I was sure the old fellow would never make it to the other side of the road when I struck him.
• To avoid hitting the bumper of the car in front I struck a pedestrian.
• The pedestrian had no idea which way to run as I ran over him.
• The car in front hit the pedestrian but he got up so I hit him again.
• I saw a slow moving, sad faced old gentleman as he bounced off the roof of my car.
• A pedestrian hit me and went under my car.
• I saw her look at me twice. She appeared to be making slow progress when we met on impact.

Accidents with other vehicles.

• I collided with a stationary truck coming the other way.
• A truck backed through my windshield into my wife's face.
• The other car collided with mine without giving warning of its intention.
• My car was legally parked as it backed into another vehicle.
• When I saw I could not avoid a collision I stepped on the gas and crashed into the other car.
• I started to slow down but the traffic was more stationary than I thought.
• The accident occurred when I was attempting to bring my car out of a skid by steering it into the other vehicle.
• I was backing my car out of the driveway in the usual manner, when it was struck by the other car in the same place it had been struck several times before.
• I was unable to stop in time and my car crashed into the other vehicle. The driver and passengers then left immediately for a vacation with injuries.
• The gentleman behind me struck me on the backside. He then went to rest in a bush with just his rear end showing.
• The car in front of me stopped for a yellow light, so I had no choice but to hit him. (She pushed him through the intersection)

Collisions, calamities, and injuries.

• Coming home I drove into the wrong house and collided with a tree I don't have.
• I told the police that I was not injured, but on removing my hat found that I had a fractured skull.
• I pulled away from the side of the road, glanced at my mother-in-law and headed over the embankment.
• I thought my window was down, but I found it was up when I put my head through it.
• As I approached an intersection a sign suddenly appeared in a place where no stop sign had ever appeared before. I was unable to stop in time to avoid the accident.
• In an attempt to kill a fly, I drove into a telephone pole.
• I saw two kangaroos having it off in the middle of the road. So I hit them, which caused me to ejaculate through the sunroof.
• I was thrown from my car as it left the road. I was later found in a ditch by some stray cows.
• The telephone pole was approaching. I was attempting to swerve out of the way when I struck the front end.
• I pulled in to the side of the road because there was smoke coming from under the hood. I realized there was a fire in the engine, so I took my dog and smothered it with a blanket.
• The claimant had collided with a cow. The questions and answers on the claim form were - Q: What warning was given by you? A: Horn. Q: What warning was given by the other party? A: Moo.

Who is to Blame?

• No one was to blame for the accident but it would never have happened if the other driver had been alert.
• I didn't think the speed limit applied after midnight.
• I had been shopping for plants all day and was on my way home. As I reached an intersection a hedge sprang up, obscuring my vision and I did not see the other car.
• The indirect cause of the accident was a little guy in a small car with a big mouth.
• I was going at about 70 or 80 mph when my girlfriend reached over and grabbed my testicles so I lost control.
• I was on the way to the doctor with rear end trouble when my universal joint gave way causing me to have an accident.
• On approach to the traffic lights the car in front suddenly broke.
• The accident was caused by me waving to the man I hit last week.
• Windshield broke. Cause unknown. Probably Voodoo.
• No witnesses would admit having seen the mishap until after it happened.
• I had been learning to drive with power steering. I turned the wheel to what I thought was enough and found myself in a different direction going the opposite way.
• The accident happened when the right front door of a car came round the corner without giving a signal.
• I had been driving for forty years when I fell asleep at the wheel and had an accident.
• I left for work this morning at 7am as usual when I collided straight into a bus. The bus was 5 miniutes early.
• An invisible car came out of nowhere, struck my car and vanished.
• I knew the dog was possessive about the car but I would not have asked her to drive it if I had thought there was any risk.
• The accident happened because I had one eye on the truck in front, one eye on the pedestrian, and the other on the car behind.
• I started to turn and it was at this point I noticed a camel and an elephant tethered at the verge. This distraction caused me to lose concentration and hit a bollard.

Fraud Friday

When Insurance Fraud is a Sport

The accountant tapped the bumper of the van in front of her while creeping along in Tampa's rush-hour traffic. The van's driver said he was fine. Then he called an accident referral service.

When the dust settled months later, the bills topped $52,000, all paid by the accountant's car insurance company.

Read More Here...

Claims Conversations

CLAIMS CONVERSATIONS

Roger Howson

Claims Dispute Resolution

PSAA Newsletter Editor and Education Chair

On Thanksgiving morning my wife Barbara and I enjoyed a five mile walk in a torrential downpour. We returned home drenched from head to toe, chilled to the bone, and smiling happily because for the first time in many years we wouldn’t be capping our Thanksgiving weekend with a 26.2 mile run/walk/limp through rain, sleet, snow, and intermittent sunshine at the Seattle Marathon.

Congratulations to those of you who competed in this year’s annual test of your endurance (and sanity) at any one of the Turkey Trots, marathons, half-marathons, or Black Friday bloodbaths. Those of us conscientious objectors who stayed closer to home and watched your self-abuse on the evening news may salute you, but we definitely don’t envy you.

Speaking of questionable sanity (people question mine all the time); I’m wondering what poor liability adjuster has to handle the claims by the many Black Friday shoppers pepper sprayed by overly aggressive X-Box customers. (Why are these psycho shopper stories always about Wal-Mart; don’t any nut jobs ever shop at Nordstrom?) I find it incredible that someone is able to spray, pay, and get away without being stopped, assaulted, or caught on a smart phone or the store’s surveillance camera.

My family, friends, and acquaintances who are Black Friday veterans say I just don’t understand the whole festival-like frenzy for deep discounts while (very limited) supplies last. Yes I do. We once had a dog who acted out like these Black Friday shoppers, and the humane society made us quarantine her until the courts could decide whether or not she should be put down.

While the rest of the world revels in the holiday lights, glitter, and glitz, festive music blasting unrelentingly from speakers in every corner of every open space, and the hordes of humanity in search of the perfect gift (although REALLY scoping out the gifts they’re hoping to receive); the holidays are actually a difficult time for claims professionals.

The upbeat holiday music and merriment masks a darker anxiety that surfaces among claimants and policyholders during this time of year. They expect their claims to be paid quickly and extra generously so that they can use those proceeds to overspend on Christmas and Hanukah gifts, but they can’t get to us the claims documentation we’ve requested because they’re hopelessly overwhelmed by the demands of company parties, year-end reporting, family and neighborhood gatherings, personal entertaining expectations, gift-buying, and perpetual good cheer.

At the same time, we’re buried in claims because just like our claimants we’re also hopelessly overwhelmed by those very same demands of company parties, year-end reporting, family and neighborhood gatherings, personal entertaining expectations, gift-buying, and perpetual good cheer.

It’s hard enough keeping up with our normal work flow during the rest of the year, but from Thanksgiving through the first week in January we’re faced with holiday interruptions, deadlines that are real (fiscal year-end reporting, claims pending inventory, etc.) and artificial (settlement demands that expire just before Christmas), the corporate “use it or lose it” vacation policy, and the cumulative exhaustion from a year that has gone too long and is ending too early.

The bah humbug irony is that, regardless of the very real stress and anxiety acknowledged in the paragraphs above, every one of us looks forward to this time of year because it’s exhilarating, exuberant, and extravagant. So long as we remember to appropriately appreciate the overstimulation and high drama in the good spirit in which it is intended we’ll all be fine. Besides that, after the presents are bought, wrapped, unwrapped, rewrapped, and re-gifted and the New Year is riotously celebrated we’ll have another ten months to recover before the holiday chaos all starts up again.

Speaking of overstimulation and high drama, thank you all who attended the inaugural PSAA Holiday Celebration at Emerald Downs. And congratulations to the PSAA Holiday Committee and Board Members who really put themselves out to make sure that this year’s event would be one to remember.

Those of you who don’t remember anything from this raucous celebration might want to check Facebook, Google, Snapfish, police incident reports, and anywhere else there’s photographic evidence of your behavior that evening. Take our word for it- you had a GREAT time.

May you all enjoy your Christmas, Hanukah, Kwanzaa, and New Year celebrations, and we look forward to seeing every one of you at the next PSAA Meeting at Billy Baroo’s on Friday, January 20th at 11:30am.

Fraud Friday

Check out The Insurance Hall of Shame.

Here are a few excerpts....you won't want to miss the rest!

Burning with desire. Kenneth Allen led an arson ring that torched 50 homes and hauled in millions in bogus insurance claims, mostly in the Indianapolis and Muncie areas. Allen’s gang usually bought low-priced fixer-upper homes and loaded them with used furniture to inflate the claims.

Allen even recruited a crooked insurance adjuster to ensure the claims slid past the insurers. The scheme was so brazen that one home had no furnace oven or sink—but did have a big-screen TV, video game console and space heater all plugged suspiciously into the same outlet. Allen received four years.

Judging the judge. Elected appellate judge Michael Joyce collected $440,000 from auto insurers after lying that a 5 mph bumper bender left him in constant pain and virtually crippled.

But the Erie, Pennsylvania jurist went swimming, was an avid golfer, did in-line roller blading and went scuba diving in the Caribbean. Joyce also earned his pilot license and flew an airplane at least 50 times. And he passed the difficult pilot licensing test despite claiming he had brain damage that made it hard to think clearly. Joyce will be sentenced in 2009.

Triathlon tricks. Samuel Aaron Brabson claimed a car crash left him nearly crippled and largely confined to a wheelchair. The Richmond, Va. man made more than $1.2 million in disability claims, and even had Meals on Wheels helping him out.

But all along, Brabson competed in triathlons and took girlfriends on grueling mountain hikes. When a friend saw him in a store with no sign of disability, he told her he was Brabson’s twin. Brabson has no twin. He received one year, thanks in part to solid sleuthing by the Virginia State Police.