Few auto insurance questions..?

Question

Hi,
Doing a report for law class(Who said law school is easy?) about insurance fraud and their processing in general.
1)So when you file a claim,how long does it take for them to catch fraud?
2)What happens after you file a claim?Do they start to investigate everything?Is fraud usually caught in this part of the process?
3)What if the other person frauds and lies?What happensthen?
4) Are the consequences different?Like if you lied about one small thing VS a big thing?
5) What if they find out you frauded AFTER everything is done? (Like repairs)
6) Do they find out if you lie before they repair the vehicle?(Or hand over the check otherwise..)
7) Can they change their minds about paying after they already paid and make you pay it?
8)What if the police reports say you are not at fault but you said something different?
*Basically, this being about fraud,I need to know about frauding insurance.
Share your stories!Thank you so much and Bless you for helping this burnt out college student.

Answer 1

Even though it goes against my grain to do "homework" for students, I will try to answer a few of your questions:

If you fraudulently file a claim (say by claiming your car was stolen) and upon investigating, they discover that you had it stolen, naturally they will deny the claim and PROSECUTE for attempted fraud! Usually fraud is easily detectable by experienced insurance adjusters early in the process of investigating claims (they sense when a person is lying to them, somehow!).

When a claim is filed, an investigation begins immediately. Police reports, witnesses (if an accident has resulted), and other factors are gathered. Any discrepancies are immediately "flagged" for follow-up. It is at this point that fraud is usually discovered.

If the other person commits fraud and perjures himself, it usually will not result in any action being taken by your insurance company, other than notifying his/her insurance carrier.

The consequences don't rely on the size of the misdirection - fraud is fraud. If you tell them you park your car in a garage and it was actually on the street and got stolen, you're up the creek!

If repairs have been done and fraud is suspected, you will be responsible for the repairs; the insurance company has no obligation to pay off on a fraudulent claim.

They will withold satisfaction on the claim if they even suspect fraud, but they may notify you as to the reason they are witholding payment. In no case will they pay for repairs, doctor bills or any other loss if fraud has occured.

If there is a contradiction between police reports and other statements (or investigation results), you will not receive the payments and may be prosecuted for attempted fraud.

Hope this helps (I am a trained paralegal, with some experience in this matter).

Answer 2

First, you are very bold in asking that question here. Most folks who have committed fraud aren't going to spill their beans here.

Your best bet is to talk to your own insurance agent, assuming you own a car, or have renters insurance. Hopefully they've dealt with enough fraud to answer your questions.

I can tell you this: unless the amount the insurance company pays out is more than is customary, or the case itself seems unusual, the insurance company is going to keep on trucking as if no fraud has occurred...pun intended.

Answer 3

No, a minor cannot get a policy alone, because a policy is a contract between two or more adults. Even if you could, it would cost more to have a policy alone with just "the state minimals" than to be added to their policy with full coverage. Policies on which all drivers are males under 20 cost several times as much as policies that also have drivers over 35.

Answer 4

I have the answers to all your questions (20+ year insurance vet) but I will NEVER assist a damn lawyer or law student with anything. I only pray this is a class and not a career.

Answer 5

What class is this for exactly? All the lawyers I know have no idea what this class of yours could be, additionally, none of the course catalogs I've read (which are several) have a class entitled Insurance Fraud. Sounds more like personal gain to me.

Answer 6

Insurance fraud is uncovered because somebody screws up or gets greedy. and a claims person gets curious. .
I worked in Health claims, and once saw a claim,and the dx was "gull bladder,"and the treatment was " removal of infected parts."
i went to my boss/ He dismissed the "gull bladder " as sloppy writing, but questioned the"removal of infected parts. " Like, what surgeon only removes parts of the "gullbladder, " they remove the whole thing.
I called the surgeon to ask what hospital he removed it at. ( not that it would have made a difference. )). we were doing a survery. (Yea, right!) He said he never heard of the patient. i explained, i had a claim for removal of "infected parts. ". He asked WTF Iwas talking about. i explained, and he said he was going to call the district attorney, and i could expect a call from him.
I never saw the claim again. It was sent to our legal dept. If the claimant would have wrote the medical term for gall bladder removal, it would have been paid without a second thought.
Docctors don;t think much about forgery.((This wasn't auto ins, but I thought you'd be interested.))