Wednesday, February 3, 2010

USA Police & Fire Departments


I worked property and liability claims during my claims career. Often times during the outset of my investigation, I would ask if there was a quick reference to access USA police and fire departments. Well,I found two such sources for you. You may have heard of these two sites. If not, they should prove to be helpful. I will update this post as I discovered more sites such as these. If you have similar sites please submit them.











Sunday, January 10, 2010

SIU Presentation

SIU (Special Investigation Unit) is an integral part of insurance investigations. Insurance fraud is the act of falsifying or exaggerating the facts of an accident to an insurance company to obtain payment that would not otherwise be made. Common types of insurance fraud are staged accidents, exaggerated injuries, and inflated medical bills. We have developed a SIU training module that addresses SIU investigations fully. The complete course is 44 slides and contains full content, audio, self grading test and much more. See sample clips below.

Saturday, December 12, 2009

Top 5 Pet Claims













The most wonderful time of the year is also one of the most dangerous for pets. In order to assess the impact of the holidays on pet health, Veterinary Pet Insurance Co. (VPI), the nation's oldest and largest provider of pet health insurance The company found that last year more than 200 policyholders spent Christmas Day at the veterinarian's office—most with pets receiving treatment for accidental injuries or dietary indiscretion.

The top five Christmas Day claims of 2008:
1. Gastritis/Enteritis
2. Lacerations or Bite Wounds
3. Soft Tissue Trauma
4. Foreign Body Ingestion
5. Chocolate Poisoning”

Christmas Day is the last day most pet owners want to spend at an emergency clinic with a sick or injured pet," said Dr. Carol McConnell, vice president and chief veterinary medical officer for VPI. "Fortunately, many of the claims we receive for conditions treated on Christmas Day can be prevented.

The data, mined from more than 475,000 VPI-insured pets nationwide, reveals that claims treated on Christmas Day skew towards accidents requiring emergency treatment, perhaps because most regular veterinary clinics are closed on December 25. The other 364 days of the year, claims for medical conditions such as skin allergies, ear infections and urinary tract infections prove far more common than claims for the majority of conditions treated on Christmas Day. Only gastritis/enteritis ranked among the top 10 medical claims received by VPI in the full year of 2008. Other claims submitted with a December 25 treatment date included claims for broken bones, gastric torsion, gastric ulcers, torn nails, allergic reactions and cruciate ruptures.

Wednesday, December 9, 2009

PROPERTY CLAIMS TIP: ARSON
A property claims professional should always be aware of the indicators of an arson fire. The main elements of an arson fire investigation revolve around motive, opportunity, and an incendiary fire.

These indicators should help isolate those claims which necessitate further investigation. No single indicator by itself is necessarily suspicious. Even the presence of several indicators, while suggestive of possible arson, does not mean that arson or fire related fraud has been committed. Indicators of possible arson are not evidence that arson has occurred.
General indicators of arson or fire-related fraud include:
  • Building and/or contents were up for sale at the time of the losss
  • Suspiciously coincidental absence of family pet at the time of the fire
  • The insured had a fire loss at the same site within the preceding year; the initial loss, though small, may have been a failed attempt to liquidate contents
  • Building and/or business was recently purchased
  • Commercial losses include old or nonsaleable inventory or illegal chemicals/materials
  • Insured or insured's business is experiencing financial difficulties
  • Fire site is claimed by multiple mortgageesbuilding is in deteriorating condition and/or lacks proper maintenance
  • Fire scene investigation suggests that property/contents were heavily overinsured
  • Fire scene investigation reveals absence of items of sentimental value
  • Fire scene investigation reveals absence of remains of items normally found in a home or business (television, clothes, personal items, business records)
  • Fire occurs at night, especially after 11 p.m.
  • Commercial fire occurs on holiday, weekend, or when business is closed
  • Fire department reports fire is incendiary, suspicious or unknown


Tuesday, December 8, 2009

AUTO CLAIMS TIP: INTERSECTION ACCIDENTS

When intersection accidents happen, there is usually a clear reason why. The seasoned auto investigator will often engage in a series of questions to help guide them to the proper conclusion. Most often in intersection accidents the culprit is the result of some very basic breaches of traffic rules. This is not an absolute but the following checklist of investigative items will serve as a good start to investigating an intersection accident. My experience leads me to start with these questions and from there, I will usually probe deeper to get the deciding facts. The list:





Speed
Management of the vehicle
Adherence to traffic signals
Visibility
Obstructions
Weather conditions
Road conditions
Proper Vehicle signaling used
Point of impact
Skid marks
Who had the right of way?
What color was the traffic light for each driver
How big of an intersection
Any drinking or drugs involved
Was any of the drivers sited and if so, why?



Thursday, December 3, 2009


Property claims estimating is a challenging and exacting task. Those who have mastered the proprietary software tools are few and specialized. Have you ever wondered what exactly is involved in property estimating software? Well, you are in luck. Claimstrainer has put together several brief training videos to highlight the software features. We also provide a visual introduction to these unique programs. Simply Click on the Link below:


















THE 50 STATE INSURANCE DEPARTMENT LINKS

The state department of insurance is a destination that offers consumers, agents and other insurance professionals excellent insurance information. The following list offers links to all 50 departments of insurance.

Alabama Department of Insurance
Alaska Division of Insurance
Arizona Department of Insurance
Arkansas Insurance Department
California Department of Insurance
Colorado Division of Insurance
Connecticut Insurance Department
Delaware Insurance Department
District of Columbia Department of Securities and Insurance Regulation
Florida Department of Insurance
Georgia Insurance and Fire Safety Commissioner
Hawaii Division of Insurance
Idaho Department of Insurance
Illinois Department of Insurance
Indiana Department of Insurance
Iowa Insurance Division
Kansas Insurance Department
Kentucky Department of Insurance
Louisiana Department of Insurance
Maine Bureau of Insurance
Maryland Insurance Administration
Massachusetts Division of Insurance
Michigan Office of Financial and Insurance Services
Minnesota Department of Commerce
Mississippi Department of Insurance
Missouri Department of Insurance
Montana State Insurance Dept
Nebraska Department of Insurance
Nevada Division of Insurance
New Hampshire Insurance Department
New Jersey Department of Banking and Insurance
New Mexico Insurance Division
New York State Insurance Department
North Carolina Department of Insurance
North Dakota Department of Insurance
Ohio Department of Insurance
Oklahoma Department of Insurance
Oregon Insurance Division
Pennsylvania Insurance Department
Rhode Island Department of Business Regulation
South Carolina Department of Insurance
South Dakota Division of Insurance
Tennessee Commerce and Insurance Administration
Texas Department of Insurance
Utah Insurance Department
Vermont Department of Banking, Insurance, Securities and Health Care Administration
Virginia Bureau of Insurance
Washington State Insurance Commissioner
West Virginia Board of Risk & Insurance Management
Wisconsin Office of the Commissioner of Insurance
Wyoming Insurance Department