Case Factors that Could Suggest Plaintiff Fraud
Do you know what will get the case to insurer’s “Special Investigation Unit” for a potential fraud investigation? Here’s some things to consider of which you should be made aware.
Evasive identification. A claimant will refuse to or will not produce correct identification. This may raise red flags in the insurance adjuster’s mind, then leading to a serious suspicion of fraud claim.
Curious address or no solid address. The claimant then uses addresses of friends, post office boxes, family, work, and has no known permanent address.
Claimant avoids U.S. mail, prefers hand delivery of documents. This signals the claimant is wise to mail fraud and is avoiding the mails for that purpose.
Claimant attitude. The claimant is perceived as being pushy, overly demanding a quicker settlement or decision and is familiar with claims handling processes.
Financial distress. The claimant was experiences financial problems or domestic issues prior to the claim.
Lifestyle inconsistencies. Claimant’s lifestyle doesn’t match with known income. If the claimant’s lifestyle is opulent compared to income, adjusters wonder what sources of earnings exist, through illicit activity or insurance settlements.
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