Insurance fraud is a major problem and it is no different in auto theft claims. There are as many financial motivations as there are reported thefts. The problem though is these claims are not based on their own merits, and it is far easier to target all insured’s with the same brush.
The insurance fraud investigation that the investigator is doing applies an element of fraud in the investigation that gives the company a great advantage over the insured. In my view, insurance companies have basardized the facts with assumption and speculation perceived to be fact.
Also known as preponderance of the evidence!
In order for the auto theft investigation to proceed the investigator needs an expet to determine as to how the reported stolen vehicle was last driven.
The investigator goes to the company’s vendor list and hire a Certified Forensic Locksmith. Does this mean he is licensed by any state entity as an expert in auto theft or forensic locksmithing? No! It only means that he paid to be a member of an association and that he took a test, which then awarded him a certificate. In the case of CFL however, the certificate should come into question because the certifying entity the IAIL (International Association of Investigative Locksmiths) no longer exists and it hasn’t for years-www.iail.org.
What purportedly seperates the experience from a forensic locksmith over that of an ordinary locksmith?
A CFL by description has the ability to apply his knowledge as that of a locksmith to disassemble an ignition lock, examine the components under a microscope and compare identifiable tool marks from the supplied keys to the tumblers. He has the ability to memorialize his findings by photos taken from the microscope which are included in a report for his client the insurance investigator. He alledgedly attempts to eliminate hypothese related to a thief driving the vehicle as compared to the insured that has a key for the vehicle.
Other duties are to be called to do depositions and to testify in court.
For those not aware if you have an auto theft claim, the insurance company has rigged the game against you!
I was a contributor for the Insure.com in the 90s. This article that I contributed to was introduced about 1999 and still holds true and the insured would be well off reviewing it.
This is truly a scientific process that has been played hundreds of thousands of times throughout the US and Canada. It is a game for the insured known as “You Can’t Win!”
The investigation questions have been sanitized and sanitized again. So much so, it is almost robotic for the claims handler and the investigator. Yet, how many times has the insured been under a special Investigation on his/hers reported stolen vehicle? Once?
It is extremely common from my over 20 years of experience to hear the standard answer from an attorney that took one of these cases. I would ask as to how many auto theft claim denial cases have they handled. The usual answer is “This is my first one.”
OK, lets look at the odds here. You as the inured have never been through an investigation with the carriers ultimate denial. The attorney has his/hers first case of this type. You are up against a process that has been used hundreds of thousands of times throughout all carriers across the US and Canada. What is your teams odds at prevailing?
How many of these claims have I been involved for the insurance companies and against the insurance companies? Thousands!
What do I know about the auto theft investigation process? Please keep in mind, I am learning everyday, but I am highly profficient in the investigation process, including the questions asked of the insured and the correct way to answer them, not the way the average insured would attemp to. After all, they are innocent and have nothing to hide. Actually, the investigator really appreciates this attitude, because it assists them in building their case of denial.
Now, I am not a lawyer and I never give legal advice, however I share my experiences from these investigations and the one thing the insured is not told in a civil situation such as this, where it is required known as Miranda rights when being charged criminally. That is everthing you say will be used against you!
Let’s say that when you give your recorded statement, the estimate that the vehicle was found missing was about 7 pm. You state that in your recorded statement. Over the week you were talking t some friends and you realize that you didn’t notice the vehicle missing at 7 pm because you were with them until 9 pm. You contact the insurance company to correct the record. No big deal right? To the insurance company, you have just lied to them! It’s very difficult to change any statement, because no matter what you are told that they want to pay the claim, blah, blah, blah, it’s a lie, because the investigator’s work performance is graded on how many investigations they do, and better yet, how much money they saved their employer by denying a claim!
So, from the very begining, the insured is looked at as dishonest. Now, what would make me say that? Investigators are commonly indoctrinated that all theft claims are bogus. Some are fraudulent, while others are not, but the Special Investigation Unit (SIU) is mainly comprised of ex-cops that believe no one! THe vehicle reported stolen is equipped with an anti-theft transponder system making the vehicle unstealable. Since deemed unstealable, the theft claim by default now enters into a fraud investigation.
The burden of proof is on the carrier, but not the reasonable doubt threshold or clear and convincing threshold. In civil cases they are required to meet the very flimsy threshold of preponderance. This means that inuendo and assumption are used to make it appear as though the insured submitted a fraudulent claim. It does not mean they have to prove it was a fraudulent claim.
Motive: Many insureds will ask themselves or the attorney in which you are suing the insurance company, where is the motive?
The motive is based on the wild imagination of the investigator. Remember that credit card or car payment 6 months ago there was a dispute as to whether it was paid on time or not? Well, there is your motive! You needed the cash the insurance company was going to give you for your totalled vehicle!
The only problem (unimportant detail for court) that you the insured was not going to be the benificiary, the lien holder was! It sounds better with the insurance defense attorney telling the jury the insured would get the cash for the vehicle, because this plays into their motive!
Possibly, when you were purchasing your vehicle, the finance department at the dealer stated that you needed to get gap coverage for an extra charge. Most insureds when buying a vehicle, especially when new are so excited to get it, they barely pay attention to what the finance manager is hitting them for. Just so you are aware, in California some finance mangers make up to $60-$70,000 PER MONTH! They are the ones that will sell you “spiffs” like extended warranties, after market accessories, and gap insurance.
Gap insurance is very common because the dealers rip people off on their trades when the current vehicle they owe more than the vehicle is worth. The gap covers the difference between the actual cash value of the vehicle and what is owed on the vehicle. Gap insurance to an investigator is a red flag, because it is figured the insured did not want the vehicle anymore and can walk away from the debt free and clear.
Other red flags are if the vehicle is only missing for a short period of time, recovered in close proximity of the theft scene or recovered burned, these are huge red flags.
If no broken glass is found at the scene, the insured must be lying about the theft if it was lacked as the insured stated. I love using this analogy- A locksmith has to get into the locked vehicle quickly. How many times do you think a locksmith throws a brick through the glass to enter a locked vehicle?
What the investigator is doing is taking a negative view on the theft claim. Where insureds get into real trouble is trying to defend themselves, and no a lawyer cannot protect you. This is not a trial and the lawyer has no standing. Besides, insurance companies are not intimidated by lawyers, because they have their lawyers dealing with insureds lawyers every day!
The insured is in a hole and they keep digging, commonly they think they can get the claim to settle. If that were true, you wouldn’t be under investigation. So often, the insured and sometimes their attorney screw these investigations up so bad, no one can help them!
I consult the insured through the claim including when they are required to give sworn testimony. We have hundreds of hours of sworn testimony up against some of the most ruthless and unprofessional lawyers out there. We have survived, but we also learned a lot, with no one but ourselves learning.
Over 90% of the claims that were scheduled for denial, we got paid!
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