by MaxHerr » Wed Jul 07, 2010 11:24 pm
From the CA Dept of Insurance July 7, 2010:
Insurance Commissioner Poizner today announced the arrest of Mohammad Shablid, 48, of San Jose, for allegedly falsely six separate insurance claims for preexisting damage to his vehicles.
"When you lie to your insurance company, you commit insurance fraud," said Commissioner Poizner. "Committing insurance fraud is never worth the legal trouble, fines and possible jail time you will face."
He was arrested on June 28 and booked at the Santa Clara County Jail. He was booked on a $30,000 felony warrant. If convicted, each felony charge has a potential 5 year maximum sentence with a $10,000 potential maximum fine.
From December 2008 through January 2009, Shablid allegedly made six different automobile insurance claims with five different insurance companies for two of his automobiles. In five of the claims, Shablid said he was the victim of a hit and run accident. According to investigators, all of the damage he claimed occurred was damage that had already existed on his vehicles, or damage that he had previously been compensated for.
In his sixth and last claim, Shablid said that he was driving and struck his apartment building in the parking structure. In that claim, he included pre-existing damage, for which he had already been compensated. In many instances, Shablid would cancel his insurance policy upon a claim being paid and then open a new policy with a different insurance company. The insurance companies involved included Allstate, 21st Century, AIG (now 21st Century), Esurance, and Travelers Insurance.
Shablid allegedly made material misrepresentations to investigators from five different insurance companies.
The case is being prosecuted by the Santa Clara County District Attorney’s Office.
Commissioner Poizner oversees sixteen CDI Enforcement Branch regional offices throughout the state. Nearly 2,800 insurance fraud-related arrests have been made by CDI since Commissioner Poizner took office in 2007 - more arrests than have been made during any other three year period, under any previous insurance commissioner.
When you do the math, "six claims with five insurance companies", it should be apparent that one of the companies received two claims. Give credit to the claims examiner who recognized the same damage being reported a second time and blew the fraud whistle.
What's unfortunate is that insurance companies are not allowed to communicate things like this directly with one another -- notice that each incident, except the last, was reported as a "hit and run" meaning only one insurer was involved in the claim. If not for the SIUs and California's vigorous anti-fraud stance, this kind of stuff would go unnoticed for years.
California now assesses auto insurers -- passed on to policyholders -- a fee to support fraud intervention and prosecution. The Commissioner recently doled out a total of nearly $30 million to many of the counties for their continued efforts to combat fraud, the majority of which is auto-related. Workers' comp and medical insurance fraud compete each year for the #2 and #3 spots.
Insurance Commissioner Poizner today announced the arrest of Mohammad Shablid, 48, of San Jose, for allegedly falsely six separate insurance claims for preexisting damage to his vehicles.
"When you lie to your insurance company, you commit insurance fraud," said Commissioner Poizner. "Committing insurance fraud is never worth the legal trouble, fines and possible jail time you will face."
He was arrested on June 28 and booked at the Santa Clara County Jail. He was booked on a $30,000 felony warrant. If convicted, each felony charge has a potential 5 year maximum sentence with a $10,000 potential maximum fine.
From December 2008 through January 2009, Shablid allegedly made six different automobile insurance claims with five different insurance companies for two of his automobiles. In five of the claims, Shablid said he was the victim of a hit and run accident. According to investigators, all of the damage he claimed occurred was damage that had already existed on his vehicles, or damage that he had previously been compensated for.
In his sixth and last claim, Shablid said that he was driving and struck his apartment building in the parking structure. In that claim, he included pre-existing damage, for which he had already been compensated. In many instances, Shablid would cancel his insurance policy upon a claim being paid and then open a new policy with a different insurance company. The insurance companies involved included Allstate, 21st Century, AIG (now 21st Century), Esurance, and Travelers Insurance.
Shablid allegedly made material misrepresentations to investigators from five different insurance companies.
The case is being prosecuted by the Santa Clara County District Attorney’s Office.
Commissioner Poizner oversees sixteen CDI Enforcement Branch regional offices throughout the state. Nearly 2,800 insurance fraud-related arrests have been made by CDI since Commissioner Poizner took office in 2007 - more arrests than have been made during any other three year period, under any previous insurance commissioner.
From December 2008 through January 2009, Shablid allegedly made six different automobile insurance claims with five different insurance companies for two of his automobiles.
In his sixth and last claim, Shablid said that he was driving and struck his apartment building in the parking structure. In that claim, he included pre-existing damage, for which he had already been compensated.
When you do the math, "six claims with five insurance companies", it should be apparent that one of the companies received two claims. Give credit to the claims examiner who recognized the same damage being reported a second time and blew the fraud whistle.
What's unfortunate is that insurance companies are not allowed to communicate things like this directly with one another -- notice that each incident, except the last, was reported as a "hit and run" meaning only one insurer was involved in the claim. If not for the SIUs and California's vigorous anti-fraud stance, this kind of stuff would go unnoticed for years.
California now assesses auto insurers -- passed on to policyholders -- a fee to support fraud intervention and prosecution. The Commissioner recently doled out a total of nearly $30 million to many of the counties for their continued efforts to combat fraud, the majority of which is auto-related. Workers' comp and medical insurance fraud compete each year for the #2 and #3 spots.
Posted: Thu Jul 08, 2010 02:33 am Post Subject:
Hey Max...good one! :shock:
Reminds me of when I was just a little insurance tot. I was working SIU for Safeco, and got an HO4 burglary loss assigned to me. The initial adjuster on the loss had the proverbial hairs stand up on the back of her neck and turned it into SIU.
HO4 contract with a policy limit of $30k, which was a big limit in 1982/83, endorsed for replacement cost. The loss consisted of a lot of high-end (for that time) electronics, a couple of art pieces and some miscellaneous stuff. I set the claim reserve at $28k (gee...surprise?).
The claimant had receipts for everything...funny thing was that every piece was purchased within 3 days of each other. Still, had the receipts and they were originals. Noticed the effective date of the coverage was just a month or so before the loss, an obvious red flag. So, when I looked into it, there was a plausible reason for both- the guy had just moved into his new place about a month earlier after getting divorced and his ex got all of his electronics. Pretty good excuse, too. Worked for me and my boss at the time. Showed us the divorce papers and everything. The police report was on target, had signs of forced entry, the cops didn't notice anything unusual, and so it was game on settling the loss.
A couple of days later, I was talking with a fellow SIU guy from another carrier and we were complaining about the case loads we had. He started whining about this "renter's loss where the guy nailed us for about $25k" and my head started whirring and churning.
"What was the guy's name? What kind of stuff was taken? Was it lots of electronics? Where does he live? How long was the policy in force?" And on and on and on. We ran to our offices and compared notes. The guy had different names, different "original" receipts, different bank accounts, different everything. Got ahold of my buddy up at the Insurance Crimes Bureau and told him what was going on, and I thought he had died and gone to heaven when I was done. He was so excited about the whole thing and was seriously looking forward to busting the guy.
After about a week of investigation, it was determined that this guy had taken out 14 different HO4 contracts with different carriers, claimed different amounts with each of them, and if he would have gotten away with it, would've sucked about $400k out of the carriers pockets. Again, this was roughly 1983 and that was a whole lotta money back then.
Interestingly enough, ICB had me direct the claimant to mail in the final proof of loss statement. It was great. When he got busted (at my offices, right in front of me!), in addition to the insurance fraud, they also nailed him for felony mail fraud. :D :D The look on his face when the feds came out...if only UTube was around 27 years ago :shock: :roll:
Fun fun fun til his daddy took the freedom away...
InsTeacher 8)
Posted: Thu Jul 08, 2010 03:32 pm Post Subject:
Thanks to all the privacy weenies that have screwed up the investigatory side of insurance, the same "conversation" with the other company's SIU member today would probably get both tossed into a cell along with the fraudster.
Posted: Mon Sep 20, 2010 12:24 pm Post Subject:
Teacher, it really helps to know of such experiences. The guy was truly intelligent, but luck was not in his favor. Thank your whirring and churning and that other guy, which ultimately saved it for the carriers.
Posted: Mon Sep 20, 2010 12:53 pm Post Subject: Good stuff
Nice....
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