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Donna
Kozik
www.DonnaKozik.com
Donna@DonnaKozik.com
619-297-1749
Article
Writing Sample
Fraud
Finder Phil Friday & the
Case of the Bogus Bump
Hi
friends, Phil Friday, of ERIE’s intrepid fraud
investigation department, here with another find from
our fraud files.
Why
should you give a fig about fraud? Well, the Insurance
Research Council estimated that it added between $4.3
and $5.8 billion to auto injury settlements in 2002,
which represents between 11 and 15 percent of all
dollars paid for private passenger auto injury insurance
claims that year. That’s a lot of extra clams
collected by the cunning at the expense of insurance
companies and their policyholders—sincere citizens
like you!
Onto
our tale, which I’ve named “The Case of the Bogus
Bump.”
It
was a fall day in Philadelphia when an ERIE insured, a
62-year-old computer analyst, backed his 1985 Volvo out
of a parking space—and purportedly into the claimant.
Soon after, our Policyholder received a letter from an
attorney who represented the supposedly struck man—and
the man said he sustained personal injuries from the
run-in.
But
Policyholder said he did not strike the claimant, which
caused the claims supervisor to alert our fraud
investigative unit. Senior Investigator Bob Burke took
control of the case and interviewed the insured, the
responding police officer and a witness to the alleged
accident. Again, the insured insisted he did not strike
the claimant, and there was no damage to his vehicle,
which made the story start to smell.
“The
Policyholder was very emphatic that he did not strike
the claimant,” said Investigator Burke. “He also was
cooperative and helpful during the investigation by
showing up for court dates ready to testify.”
Bob
began to have his suspicions confirmed when a witness
said she saw the claimant “gently lower himself to the
ground and start hollering”—before the insured’s
car moved a single centimeter!
“It got a break in the case when we interviewed
this witness, a nursing professor, who stated she saw
the incident and observed the alleged victim fall to the
ground,” said Burke.
It
was enough information for Bob to submit a referral to
the Insurance Fraud Unit of Philadelphia’s District
Attorney’s Office. An eight-month investigation led to
a confession from the claimant, who admitted he was
trying to scam the system. The pretender was arrested
for insurance fraud, theft by deception, false swearing
and unsworn falsification. He pled guilty to insurance
fraud and was sentenced to 1-2 years in jail. His claim
was denied, and no bills were paid for any of his
treatment. His attorney dropped his representation of
the claimant, too.
So
there you have it: another fraud fiend brought to
justice, and a fair deal given to ERIE and its
Policyholders. Thanks to our insured for his insistence
that he did not hit the storyteller and to the witness
for coming forth with an account of what really
happened, we were able put the fix on this fraud!
Until
next time, this is Phil Friday saying, “Farewell!”
Sidebox
A:
A
Few Fraud Facts
The
Coalition Against Insurance Fraud estimates auto fraud
to cost insurance companies and their policyholders
about $14 billion annually, part of the $80-billion in
estimated annual fraud overall.
But
there is some good news in the fight against fraud. The
coalition compiled data from state fraud bureaus and
reported that in 2004:
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Criminal
convictions increased 31 percent.
-
Cases
presented for prosecution rose 14 percent.
-
Investigations
initiated increased by nearly 18 percent.
-
Referrals
of suspected fraudulent actions were up 4.5 percent.
Or,
Sidebox B
What
Can You Do?
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Be
alert for forced crashes, such as intentional
sideswiping or cars that cut in front of you and
stop quickly to try to force a collision.
-
Be
leery of individuals who try to get you to leave the
scene of an accident without calling police or
obtaining a police report.
-
Be
aware of individuals attempting to get insurance
money by saying vehicle damage was done on the spot,
when it was really done previously.
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