The Expert Podcast

…So for an insurance adjuster, what are the common red flags to look for in discovering fraud in a claim? When we investigate fraudulent claims there's a number of things that pop up that are low-hanging fruit easy things to discover that might indicate a fraud and a claim First of all, if you look at items missing or items damage, if you look at, the social media of the potential claimant, you might find that those items are already shown as being damaged prior to the claim. I may also find that items. are described as a high value or certain brand of a product may not be that product in the. The postings of that person. You can also look to see if there were recent yard sale purchases A lot of times on a homeowner's claim, somebody will go and buy a bunch of cheap items to stage their house. prior to the claim so that it looks like there was a lot of things there which may be there Wasn't afterwards. You also want to look at receipts. You can find that receipts may be fraudulent. By looking to verify things like. sales tax. Is the sales tax amount correct for the purchase price? Is that the correct percentage for that jurisdiction or was it just a made up receipt? If they're high value items with no receipts that's another red flag Look to see what was the payment. purchase. valuation, was it paid in cash Was the paid with a credit card? Where are the records for those payments? If there's a bunch of high value items that were paid with cash, but they buy everything else with credit cards. what's the rationale behind that? Also look very important thing is the value or the location. Of sentimental items and important documents such as birth certificates, wedding albums, passports car titles, things that may have been removed from a car or from a home before, the damage incurred to make sure that those items were not just stashed offsite even things like pets was the pet magically at some. You know pet resort when the fire happened those types of things. Also look to see if there's fire. distress for that claimant. Are there hidden judgments? Yeah You can run a, a credit report to see if there's debt but you also can find hidden judgments by looking at. things like a title search on the property or judgments in the public record to see if that person has a sudden or recent civil judgements against them. Even things like. colleagues are there colleagues that have posted things about them? discussing distress or discussing challenges in their life. Insurance claims is a. Is a touchy area You don't want to challenge a claim when there's a valid reason to pay it. But the other hand you want to protect…your insurer from paying a claim or paying too much for a claim when there may be fraud involved.