Current Cases

So I have mentioned the responsibilities of my department and the overall mission of investigating those who commit insurance fraud. There are tons of ways to do this however and no way to get everyone. Usually the only people who get caught are those who make the fraud obvious and to make it simple, "We don't catch the smart ones" was a phrase I remember hearing. To help everyone following my posts I will explain some current cases and how we get the cases to begin with. Hopefully it will shed light on what the phrase refers too.

So a case begins with an insurance company's, such as Geicho, investigations department sending us a case that they believe fraud was in play. They determine there was a fraudulent claim through many of the same methods our department does such as differences in witness statements, inconsistencies in damages of claimed loss, and prior claims. The case will then be sent to our department and the detectives in the department will review the case and pursue further leads. Let me give some examples of the above mentioned methods of determining fraud.

Differences in Witness Statements

This pretty easy to understand but I can give examples of what people are saying and why they are saying it. One of the more common cases of insurance fraud we receive includes a legitimate accident at which the claim is justified but turns to fraud when they add certain things in the claim such as someone being in the car that was not actually in the car at the time of the incident and that person was hurt. I will summarize one case I was able to review and what was said to happen. An individual is parks along the street to allow passenger to run into a store, as the car is parked on the street another vehicle backs up into the driver side of the vehicle at a slow rate of speed when it was pulling out of a parking spot on the opposite side of the street. The car that was hit claims that the passenger was in the car and that medical attention. When interviewed, the driver and suspected passenger confirmed the story but when interviewing bystanders and witnesses it was said the passenger was in the store at time of the accident and actually came out of the store and was verbally and visibly upset while confronting the driver of the other vehicle. It was then said the passenger got in the car and began to appear injured when more bystanders walked up to the scene. After again interviewing the driver and suspected passenger of the vehicle that was hit, they confess to fraudulently claiming a passenger and injury in order to get a bigger pay out from insurance company.

Inconsistencies in Damage

This area is simple in that people that may get into a small accident will cause more damage themselves in order to get a bigger pay out. Some common things seen would include the suspects self deploying their air bags or causing a second accident purposely to cause more damage.

Prior Claims

This section refers mainly to individuals who regularly partake in insurance fraud and our on agencies radars. Unlike the two methods above that can be committed by people who are just reacting to an incident in a dishonest way, prior claims usually refers to individuals that plan staged accidents and make multiple claims or are involved in other individual's claims as an injured party. Their are individuals that make their entire living off of insurance fraud. This usually involves a group of individuals who own an auto-shop or dealers license who buy salvaged vehicles, fix them crash them, collect the insurance money, and fix the car again for far less money then they received from the insurance claim and repeat the whole process multiple times.