My new book might also be of assistance to those interested in dealing with insurance fraud.
It is “The Insurance Fraud Deskbook” peer reviewed and published by the Tort and Insurance Practice section of the American Bar Association.
The Insurance Fraud Deskbook is a valuable resource, peer reviewed by the American Bar Association, for those who are engaged in the effort to reduce expensive and pervasive occurrences of insurance fraud. It explains the elements of the crime and the tort to claims personnel, and it provides information for lawyers who represent insurers so they can adequately advise their clients. Prosecutors and their investigators can use this book to determine what is required to prove the crime and win their case.
The full text of decisions from courts of appeal and supreme courts across the country are provided so the reader can understand what happens after the investigation is completed and can apply that information to undertake their own thorough investigations. It allow claims personnel and their lawyers to understand what errors would cause a defect or a not-guilty verdict.
The effort to reduce insurance fraud requires the assistance of both civil and criminal courts. The Insurance Fraud Deskbook can help the prudent fraud investigator, insurance adjuster, insurance attorney, insurance Special Investigation Unit and insurance company management to attain the information needed to deal with state investigators and prosecutor.
Available from the American Bar Association.
They might also find it worthwhile to subscribe to “Zalma’s Insurance Fraud Letter” available free.
Insurance companies willingly pay out even knowing there’s fraud. But … they then raise the premiums of those who were “marks,” if you will. I know someone who had a 5 MPH incident, no visible damage, yet insurance paid out $12K for supposed whiplash to the driver in the first car. The second car’s insurance was raised enough to earn back the 12K in three years.
Of course I and everyone else wonders whether the second driver was really going 5 mph. But there’s facts: no physical damage to either cars, both were starting from a stop. Is it possible to have whiplash from a minor bump? OK, you can drown in a puddle. But the burden of proof? No effort made. The insurance company would have to spend $, maybe investigate the claimant, watch him to see if he plays tennis, investigate his doctor, etc. That costs thousands. Then the lawyers.
It’s more cost effective to pay out and earn back the money with increased premiums.
People who commit these frauds keep under certain thresholds, knowing that a medical case, for example, probably costs more than $12K. A simple nick on a fender, without the whiplash, might not get 12K so easily. So instead they ask for 2K or 3K – the price of an investigation.
These cons do need professionals – a crooked doctor, or at least one willing to look the other way; a body shop willing to exaggerate bigs. They say “hey, we’re not hurting anyone, just the lousy insurance people. And who hasn’t been screwed by them?”
Insurance companies could fight back. But a lot of fraud is done by organized crime and people dressed in blue. A company going after them ends up with trouble on its hands. As I’ve been told, they can’t win.
So they do the second best solution, raising premiums. Most online advice tells the person who nicked the other’s car, and learns they’re demanding huge sums, “just accept it.” Isn’t that the real problem?
I believe I am being a victim of fraud , my police report says minimal damage of $500.00 or less yes I have paid over $4500.00 with a balance of $4500 and they tell me if I miss a payment my driver license will be suspended?
I am very definate that I have been already scammed. I received a notice in the mail a few months ago saying I have to take a driving class because I have had 3 surchargeable driving accident events. If I did not, I would lose my license. I called to find out what this was all about, and I was told it was because the accident I had on 12/31/2014 which I was told by my Insurance Company, Arbella that they investagted and I was not at fault, and that was the end of it. I later found out after calling Arbella that what happened was Commerce Insurance brough Arbella to court, and they won, so they had to pay out. I asked why was I not told about this court date, and why was I never sent a surcharge to have a chance to at least fight it. The insurance company told me(now by the way Arbella wa sno longer my insurance company, because they were trying to raise my rates, because they said for the past two years they were not charging me enough!!)that they did not have to notify me, because I had nothing to do with it anymore, What, that made no sence. They told me I was sent a surcharge back in April of 2015, which is pretty funny, because that was aout the time I cancelled with them because of them wanting to up my rates. Now I have been calling Arbella for months, getting the run around. The person that had my case does not work here anymore, this case is closed, and ther is nothing you can do. I just kept calling and calling until a women finally helped me. She called her boss to tell her that I never received the surcharge to have a chance to fight it. Her boss gave permission to send me the surcharge, and I have 30 days to fight it. I received it, the wronf information for me was on it, so I called because the directions said do not send in if any information is wrong. I had to call Arbella again, she said just fix it and send it in, I said no way. SO once again she called her supervisior, and she said no do not send it in, we will fix he errors and send you a new one. Then you can send that appeal in.
So, I want to tell you about this accident.
I went to Town Fair Tire in Marlborough,Ma to get a spare tire to keep in my trunk, nothing they had to do, but sell me a tire, and I would roll it out. The man insisted that I give him my keys and wait in the waiting room for them to finish, finish what I said. The tire is right here, I paid, wait for what?Mind you , this was the second time I went there, because they were busy and told me to come back another time when they slow down.So anyways, he finally got me to go sit and wait, after about 40 minutes another sales man came in, I said oh good your done. He says umm not really can you come outside with me. I went out to see my car in a different space, the one directly in front of me. I said what the hell happened here? There was about 6 men out there, but no one could tell me what happened except for the car parked to my left, which happened to be the manager of the store. I was told my car a 1985 very heavy Cadillac Deville, that has never rolled I could puch that thing and it would not go anywhere. So I was told I rolled into the SUV in front of me, he said all you did was touch my license plate, you could not have been rolling any faster than 5 mph, so don’t worry about it, and he and 3 other sale men went back into the Town Fair Tire. I am sure they did not want to be involve in this, because what I did not then that it was probaley planned all along. So the manager that was parked to the left of me called the police right away to make a report, before I even had a chance to figure out what was happening. The police came, and while the police was looking at what happened(he did not want to hear anything from me, he had a blond in the passengers side of the cruiser. he just wanted to do a reporyt and book out of there. Before the police got there I was trying to take pictures, but I was about 5 inches close to the car, so it was hard to get any good ones, but by what I could see, it looked like a Mac truck doing 50 mph drove right into the side of it. My Caddy rolling, if it was rolling, because remember they had my keys, and they put me on the other side of the store where I could not see anything. While the police was there, the manager with the damaged car had the galls to call his autobody person to make an appointment!! After all of this, everyone was gone or in the building, I went to talk to the manager with the damage, and he jumped into his car and took off as fast as he could into the building, before I had a chance to take pictures or ask any questions. That’s when I went right to my Insurance agent and explained the whole story to her. I kept in touch with her for the next couple of months, eithe rto pay my monthly bill or just to check on this fraudulent accident charge. She just kept telling me it was being investigated. She finally told me it was over, and the man did not get anything, because I was not at fault for anything, Arbella denied his claim. That was the end of it until this October, and I’m tring to find help resolving it now. Arbella is no help since I no longer hold a policy with them. I just sent in my appeal for the surcharge that I already took the class for. I am told by the Marlborough Police sargent that it’s a year wait. He also told me his daughter went through something like this, and the company had to pay for any damage with their insurance because when they have your car and your keys and your no where around, they are responsible, am I correct??
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Well written. Thank you.
My new book might also be of assistance to those interested in dealing with insurance fraud.
It is “The Insurance Fraud Deskbook” peer reviewed and published by the Tort and Insurance Practice section of the American Bar Association.
The Insurance Fraud Deskbook is a valuable resource, peer reviewed by the American Bar Association, for those who are engaged in the effort to reduce expensive and pervasive occurrences of insurance fraud. It explains the elements of the crime and the tort to claims personnel, and it provides information for lawyers who represent insurers so they can adequately advise their clients. Prosecutors and their investigators can use this book to determine what is required to prove the crime and win their case.
The full text of decisions from courts of appeal and supreme courts across the country are provided so the reader can understand what happens after the investigation is completed and can apply that information to undertake their own thorough investigations. It allow claims personnel and their lawyers to understand what errors would cause a defect or a not-guilty verdict.
The effort to reduce insurance fraud requires the assistance of both civil and criminal courts. The Insurance Fraud Deskbook can help the prudent fraud investigator, insurance adjuster, insurance attorney, insurance Special Investigation Unit and insurance company management to attain the information needed to deal with state investigators and prosecutor.
Available from the American Bar Association.
They might also find it worthwhile to subscribe to “Zalma’s Insurance Fraud Letter” available free.
Insurance companies willingly pay out even knowing there’s fraud. But … they then raise the premiums of those who were “marks,” if you will. I know someone who had a 5 MPH incident, no visible damage, yet insurance paid out $12K for supposed whiplash to the driver in the first car. The second car’s insurance was raised enough to earn back the 12K in three years.
Of course I and everyone else wonders whether the second driver was really going 5 mph. But there’s facts: no physical damage to either cars, both were starting from a stop. Is it possible to have whiplash from a minor bump? OK, you can drown in a puddle. But the burden of proof? No effort made. The insurance company would have to spend $, maybe investigate the claimant, watch him to see if he plays tennis, investigate his doctor, etc. That costs thousands. Then the lawyers.
It’s more cost effective to pay out and earn back the money with increased premiums.
People who commit these frauds keep under certain thresholds, knowing that a medical case, for example, probably costs more than $12K. A simple nick on a fender, without the whiplash, might not get 12K so easily. So instead they ask for 2K or 3K – the price of an investigation.
These cons do need professionals – a crooked doctor, or at least one willing to look the other way; a body shop willing to exaggerate bigs. They say “hey, we’re not hurting anyone, just the lousy insurance people. And who hasn’t been screwed by them?”
Insurance companies could fight back. But a lot of fraud is done by organized crime and people dressed in blue. A company going after them ends up with trouble on its hands. As I’ve been told, they can’t win.
So they do the second best solution, raising premiums. Most online advice tells the person who nicked the other’s car, and learns they’re demanding huge sums, “just accept it.” Isn’t that the real problem?
I believe I am being a victim of fraud , my police report says minimal damage of $500.00 or less yes I have paid over $4500.00 with a balance of $4500 and they tell me if I miss a payment my driver license will be suspended?
I am very definate that I have been already scammed. I received a notice in the mail a few months ago saying I have to take a driving class because I have had 3 surchargeable driving accident events. If I did not, I would lose my license. I called to find out what this was all about, and I was told it was because the accident I had on 12/31/2014 which I was told by my Insurance Company, Arbella that they investagted and I was not at fault, and that was the end of it. I later found out after calling Arbella that what happened was Commerce Insurance brough Arbella to court, and they won, so they had to pay out. I asked why was I not told about this court date, and why was I never sent a surcharge to have a chance to at least fight it. The insurance company told me(now by the way Arbella wa sno longer my insurance company, because they were trying to raise my rates, because they said for the past two years they were not charging me enough!!)that they did not have to notify me, because I had nothing to do with it anymore, What, that made no sence. They told me I was sent a surcharge back in April of 2015, which is pretty funny, because that was aout the time I cancelled with them because of them wanting to up my rates. Now I have been calling Arbella for months, getting the run around. The person that had my case does not work here anymore, this case is closed, and ther is nothing you can do. I just kept calling and calling until a women finally helped me. She called her boss to tell her that I never received the surcharge to have a chance to fight it. Her boss gave permission to send me the surcharge, and I have 30 days to fight it. I received it, the wronf information for me was on it, so I called because the directions said do not send in if any information is wrong. I had to call Arbella again, she said just fix it and send it in, I said no way. SO once again she called her supervisior, and she said no do not send it in, we will fix he errors and send you a new one. Then you can send that appeal in.
So, I want to tell you about this accident.
I went to Town Fair Tire in Marlborough,Ma to get a spare tire to keep in my trunk, nothing they had to do, but sell me a tire, and I would roll it out. The man insisted that I give him my keys and wait in the waiting room for them to finish, finish what I said. The tire is right here, I paid, wait for what?Mind you , this was the second time I went there, because they were busy and told me to come back another time when they slow down.So anyways, he finally got me to go sit and wait, after about 40 minutes another sales man came in, I said oh good your done. He says umm not really can you come outside with me. I went out to see my car in a different space, the one directly in front of me. I said what the hell happened here? There was about 6 men out there, but no one could tell me what happened except for the car parked to my left, which happened to be the manager of the store. I was told my car a 1985 very heavy Cadillac Deville, that has never rolled I could puch that thing and it would not go anywhere. So I was told I rolled into the SUV in front of me, he said all you did was touch my license plate, you could not have been rolling any faster than 5 mph, so don’t worry about it, and he and 3 other sale men went back into the Town Fair Tire. I am sure they did not want to be involve in this, because what I did not then that it was probaley planned all along. So the manager that was parked to the left of me called the police right away to make a report, before I even had a chance to figure out what was happening. The police came, and while the police was looking at what happened(he did not want to hear anything from me, he had a blond in the passengers side of the cruiser. he just wanted to do a reporyt and book out of there. Before the police got there I was trying to take pictures, but I was about 5 inches close to the car, so it was hard to get any good ones, but by what I could see, it looked like a Mac truck doing 50 mph drove right into the side of it. My Caddy rolling, if it was rolling, because remember they had my keys, and they put me on the other side of the store where I could not see anything. While the police was there, the manager with the damaged car had the galls to call his autobody person to make an appointment!! After all of this, everyone was gone or in the building, I went to talk to the manager with the damage, and he jumped into his car and took off as fast as he could into the building, before I had a chance to take pictures or ask any questions. That’s when I went right to my Insurance agent and explained the whole story to her. I kept in touch with her for the next couple of months, eithe rto pay my monthly bill or just to check on this fraudulent accident charge. She just kept telling me it was being investigated. She finally told me it was over, and the man did not get anything, because I was not at fault for anything, Arbella denied his claim. That was the end of it until this October, and I’m tring to find help resolving it now. Arbella is no help since I no longer hold a policy with them. I just sent in my appeal for the surcharge that I already took the class for. I am told by the Marlborough Police sargent that it’s a year wait. He also told me his daughter went through something like this, and the company had to pay for any damage with their insurance because when they have your car and your keys and your no where around, they are responsible, am I correct??