Auto Claim Fraud - What is it? How Can It Affect You

Posted by Anang Fauzi On Saturday, June 12, 2010 0 comments
What is auto claim fraud? It is an intentional concealment of information to your insurance company. This sounds basic enough. You lied to your insurance company. However, there are other ways of insurance companies can construed insurance fraud. A simple "inflation of the claim" is enough; courts

will be very harsh on insureds that try to inflate claims.

Even if you inflate the claim only a few dollars, the entire claim will be denied. You will put in the "insurance black book", and if the offense is bad enough, you will be turned into the prosecutor's office. You will have a hell of a time finding a decent insurance rate for any insurance policy out there.

The problem is not that you commit fraud per se, but that you make a mistake that can be construed as fraud. For example, stating that your stereo system has MP4 capabilities because you believe that it does. If it turns out that your belief is incorrect, you will have to explain yourself. You must prove that there was no bad faith and it was a simple mistake. Most insurance companies will try to deny your claim if they believe they can save money.

Insurance companies are very aggressive assessing fraudulent trends. There are many "red flags" a claim adjuster must consider. Fire claims are "watched" and reviewed closely. Insurance adjusters will be
inquiring about your finances and making sure that the fire was not a convenient way to get rid of your car payment.

The insurance company that I used to work for had us watch gas prices very closely. They were able to draw direct relationships between the rise of gas prices and fraudulent claims. Adjusters are authorized to ask you about your finances (particularly when gas prices go up). Some of their questions can be intrusive and most insurance polices require to answer. If you lie or decline to answer, your claim can be denied because you failed to cooperate with the investigation.

It is always a good idea to read your insurance policy before you make a claim or when there is a possibility that the insurance company will construe "fraud", particularly when there are claims that are hard to explain. Reading an insurance policy is nothing like reading a book, there is special format you must follow. Visit:http://www.auto-insurance-claim-advice.com/read-your-auto-insurance-policy.html
for a detail explanation on how to read an insurance policy. It is important to really be able to understand your police and how it all fits together because when insurance companies think there is fraud, they will rather decline a claim based on something else. They will quote policy language like "failure to cooperate", "Mitigation of Damages", "Failure to Provide Proof of Loss" or even "Failure to Report Loss".

If your claim is truly fraudulent, the insurance company will not hesitate to decline your claim and turn you in. However, if the insurance company cannot prove it by preponderance of the evidence, or they do not want to point the finger directly (happens often because if they make a mistake, they could be suit), then they just decline the claim on other grounds.

If you are in one of those situations where a claim looks fishy and could be accused of auto claim fraud, but you do have a legitimate claim, then you have to make sure the insurance company has all the documents. Must have one version of events, and make sure that you read your policy so the insurance company does not try to get away with not paying what is rightfully yours.

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