“What? You Want Me To Pay My Bills With The Money You’re Giving Me To Pay My Bills?”

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Unfortunately the memo portion of a check is not strictly enforced.

This was sent to us by a public liability claims adjuster for a city risk management department:

Our office got a complaint call from a claimant with whom we’d settled for $2,500.00 after she tripped on a sidewalk. She called in two years after we’d settled with her to ask that we remove her “from our insurance system as soon as possible or turn the system off.” She said that her personal health insurance refused to pay for her injuries unless we remove her from our database.
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Well, I Suppose I Could, But I Just Don’t Feel Like Going To Jail

I had a claim assigned to me for a break-in to an insured’s house. I got a copy of the police report the insured filed, and it looked like the house was unoccupied at the time of the break-in, and the only claim was for damage to the house itself; no contents were stolen.

It took some time, surprisingly, but I finally tracked down our insured, who our documents showed as the owner of the house, and got him to meet me at the property. It was there at the meeting that he told me that he didn’t actually own the house anymore, and that the man he sold the house to made it one of the conditions of the sale that our insured keep paying for insurance on the house. While that struck me as odd, and possibly illegal, he thought nothing of it and still expected he’d be getting a check for the damaged property.

He somewhat got it when I explained what insurable interest was, and how he didn’t actually have any in the house once he sold it, and the guy he sold it to shouldn’t have made him keep insurance on a house that he no longer owned. Okay, problem solved, I thought.

But then he asked me if, despite him not actually owning the house, or suffering a loss, if there was any possibility that I could somehow find a way of paying him for the damages.

I had to then explain the concept of insurance fraud and file auditing and tell him how I really wasn’t in much of a position to lose my adjusting license or go to jail for helping him out by “finding a way” of paying him for damage to a house he didn’t own.

I think he sort of understood. Maybe.

Some Days, I’d Be Thrilled To Just Be Called A Creep

This guy got called "Sneaky Little Creep" too after helping himself to some Hors d'oeuvres off the coffee table.

This was submitted by an adjuster from South Florida

I was called a “sneaky little creep” after an insured got angry that I had brought in our company’s Special Investigative Unit to talk to him after I took his recorded statement pertaining to claim for his home being broken into. He was quite lucid during our recorded statement, which was taken in his home, which clearly had been ransacked by someone. But red flags went up after it was revealed that he had been gone from the house for ten days so he could get drug treatment, that his wife was leaving him and that the local vet was calling his home and my office asking who was going to pay for his dog that he’d left with them prior to his leaving town for rehab.

A week after I met with him at his house, he called me up angry and insisted that I tricked him into giving him a recorded statement and that he was on medicine for pancreatic cancer and not in his right mind when I met him at his home. This same insured also got angry with me several months earlier after I explained to him that I couldn’t just write him a check for damage to his vehicle, that we’d have to actually inspect his vehicle and write an estimate for the damage. He never ended up actually filing a claim for his supposed auto damage. Continue reading