by Guest » Wed Sep 24, 2008 03:34 am
Hello:
My coworker was in an accident a couple of years ago, before I started at my present company.
While looking for a document on my computer, I found a two-page itemization reflecting her "missed" hours at work. Dozens and dozens of times, going on for about a six month period.
The letter was signed by a fake HR person, and addressed to a very well-known insurance company.
I'm suspicious that this coworker submitted the information to defraud the insurance company, claiming she could not work and missed many hours and days-I know she was working during some of the times she claimed not to be. I am convinced the management didn't know anything about it.
I'm sure she received a big settlement from this fender bender, from the other agency.
Should I report my suspicions to the insurance company she received a settlement from, or-would they care?
My coworker was in an accident a couple of years ago, before I started at my present company.
While looking for a document on my computer, I found a two-page itemization reflecting her "missed" hours at work. Dozens and dozens of times, going on for about a six month period.
The letter was signed by a fake HR person, and addressed to a very well-known insurance company.
I'm suspicious that this coworker submitted the information to defraud the insurance company, claiming she could not work and missed many hours and days-I know she was working during some of the times she claimed not to be. I am convinced the management didn't know anything about it.
I'm sure she received a big settlement from this fender bender, from the other agency.
Should I report my suspicions to the insurance company she received a settlement from, or-would they care?
Posted: Wed Sep 24, 2008 05:25 am Post Subject:
Well, that all might depend upon the current status of the claim….if she has already received the claim then I doubt that reporting the fraud would make any difference. The insurance company may or may not entertain your report. And most likely they will not as it'll prove their inability to trace a fraud.
Once the claim is paid…the fraud no longer remains a part of the insurance claim procedure, rather it would become a matter of civil laws. The insurance company then has to file a lawsuit against the claimant at the civil court.
~Jeremy
Posted: Wed Sep 24, 2008 05:42 am Post Subject:
Be rest assured, the insurance companies do a thorough investigation before entertaining a claim. They will consult all the relevant documents before awarding the compensation to the claimant. Hence, if your colleague has produced fraudulent documents, the insurer is likely to find it out soon enough.
Posted: Wed Sep 24, 2008 06:08 am Post Subject:
Hi thanks for the replies. She already got the settlement. She pretended to be a Human Resources manager and made fake documents saying she missed six months of work and signed using a phony H.R. manager name and faxed to the insurance company.
Based on the fake documents she turned in (pretending to be a HR manager), they settled the claim and paid her for all her lost time. She never missed any time and was working the whole time at the company.
It's good to know the insurance company won't care now. i won't even bother to think of telling them what happened, but hopefully they'll know next time.
I'm pretty sure this person has got a tidy nest egg from several scams, she seems to always be having accidents and coming into $.
Posted: Wed Sep 24, 2008 06:20 am Post Subject:
A claim filed by the claimant strains through the various departments of fraud busters of the insurance company.
First there are the insurance adjusters. The adjusters evaluate and estimate the worth of the damage and also determine the likely amount to be awarded as compensation.
Then there is the insurance companies Special Investigation Unit. The adjuster if suspect a fraudulent claim may turn the claim for further investigation to the SIU department of the company.
The insurance investigators possess the skills and authority to identify the fraud. And they can stay on the trails till they succeed in digging the truth. Hence, your colleague may not get the luck to walk away with a lump sum money by cheating the insurance company.
Posted: Wed Sep 24, 2008 10:06 am Post Subject:
I don't necessarily agree that they won't care now...and think you are a very brave, and of high character...nice to see ......I think you should call their main line and ask to speak to someone high up in their claims dept...tell them what you know...minimally they may be able to mark this person in an index system for the next time, ANY carrier has a claim with this 'person'...thank you for a breathe of fresh air....
Posted: Thu Sep 25, 2008 04:33 pm Post Subject: fraud insurance
If the insurance company DID do an investigation, wouldn't they find out that the claim has a false employee name on it? Did I misread the information? I think if I knew someone made a claim, that was NOT true, I would report it. That's like if someone files for food stamps, and they were lying about information JUST to get them, THAT means someone who REALLY needs them, make not beable to. Hope my point makes sense.
Posted: Thu Sep 25, 2008 07:31 pm Post Subject:
If the insurance company DID do an investigation, wouldn't they find out that the claim has a false employee name on it? Did I misread the information?
Usually those forms are notarized...I can't say that I called on them very often at all just figured no one would want to risk loosing their jobs over such a thing...maybe I should've been more careful myself! (btw---glad to see you back SD...been missin' ya! )Posted: Fri Sep 26, 2008 01:57 pm Post Subject: insurance
Notarized? I never thought of that. Hello, LORI..good to be back, too. Just had alot going on. I was missing everyone, too. Thanks, again, Lori.
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