See the full video at https://rumble.com/vzyy1l-true-crime-of-insurance-fraud-video-number-50.html?mref=6zof&mrefc=2 and at https://youtu.be/FXinzjRiRw4
Barry Zalma, Esq., CFE presents videos so you can learn how to commit insurance fraud and what it takes to discourage or defeat insurance fraud.
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One of my investigators met with the property manager for an insured person to begin the investigation of a fire report that is believed to be arson. Since he had just started his investigation with a walk through the burnt-out shell, the investigator had conversations with the property manager.
“Steve, how long have you been managing this property?”
“In six months.”
“It seems that the fire started here on the service porch where the damage is most serious; do you know how it started? “
“Sure,” the manager replied with confidence and no signs of worry. “I pulled a mattress from one of the beds, piled it up against the wall by the service porch, and lit it with a Bic lighter. “Come back in time to see the flames coming from the building. I heard sirens so I just drove home.”
“Why did you do it?” asked the investigator, despairing and trying to stay calm.
“The owner asked me to burn the building and said he would pay me 10% of everything he got from the insurance company. When are you going to pay him? I could certainly use the money.”
The investigator of the murder fire case was experienced. He knew better than to accept a confession, even one given under oath. The sworn statement was only useful to counter the claim if it could be confirmed. Without confirmation, it was useless. He explained the need for confirmation to Steve.
Arson is not excluded – it’s just a fire
The insured explained that he had recently been forced to fire Steve because his work was sloppy and part of the rent that Steve took in never came to the insured. Steve had threatened to harm the insured and had almost succeeded.
The insured’s claim was paid in full. Steve, whose attempt to harm his former employer was blatantly stupid, he faced two charges of felony criminal mischief: (1) Arson; and / or (2) perjury. His case was evaluated for possible prosecution and the prosecutor – because he considered that no one was harmed after the insured was paid – refused to bring charges.
The insurer has also authorized a lawyer to sue Steve to get the money it paid back to the insured. After checking Steve’s lack of assets, a decision was made not to sue.
Each claims investigation requires a thorough and complete investigation. A confession, like Steve’s in this video, is not always what it seems. Confirmation was needed and when it was not there it turned out that Steve was just trying to hurt his employer. A false denial of the allegations based on Steve’s admission would have been wrong and would have exposed the insurer to a lawsuit in bad faith.
(c) 2022 Barry Zalma & ClaimSchool, Inc.
Barry Zalma, Esq., CFE, now limits his internship to the position of insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as a lawyer for insurance coverage and claims management and more than 54 years in the insurance industry. He is available at http://www.zalma.com and firstname.lastname@example.org.
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