This is why you dont fuck with me at work....
So the afternoon today at work was a great day. I have been swamped with parked and unattended claims, all of which require a recorded statement. They are a pain in the ass. I have 3 fraud claims come across my desk but I am only going to go over one. Mainly cause it is going to get a claim rep fired from another office.
Today I got a comp claim for a truck that had been vandalized. It came as a 2nd sell from an outside office. This adjuster that sent it to me had the file for 2 days and spoke with the insured twice during this time. No recorded statement was ever taken. Recorded statements are REQUIRED for ALL CLAIMS!!! When I got the claim and saw that there was no statement taken and then noticed the extent of the damage to the vehicle, I got pissed. According to the report, the damage to the vehicle is the windshield, entire left side has scratches, dent in the left rear quarter panel, scratches on the tailgate. I called the shop it was going to and asked if the vehicle was there. It was and told my rep to send me pictures ASAP. I emailed the first adjuster and asked them to take a recorded statement. 20 minutes later I get a response saying it was done. I reviewed the statement and it is filled with back hand comments from the claim rep. This pissed me off. The statement was complete bullshit as far as it being anywhere complete. Key points in the file at this point.....
1) Insured took the vehicle to his friends house at 8 to 9 pm saturday night and returned at 6am the following morning to notice damage.
2) Insured is a 21 year kid that JUST turned 21
3) The insured stated that he "noticed" when the vehicle was put on the tow truck that there was a hole in the gas tank.
4) Vehicle has no lift kit
I call the insured. Insured tells me that he PATCHED the hole in the gas tank so he could put gas in it to drive the vehicle. I am looking at the photos of the damaged windshield that is only being held together because of the plastic in the glass. This thing was destroyed. HOW THE FUCK DID YOU DRIVE IT?!? I ask about the scratches on the side of the vehicle. He tells me they are key marks. I am looking at the photos again and I dont see ANYTHING on the vehicle. I tell the guy I will call him back once I get the estimate and leave it at that. I call the shop again. There are scratches on the vehicle, but they are SMALL scratches that look for like bushes caused them rather then a key. None of this shit is adding up....
I reviewed the file with my manager. My manager, god love her looks at me and asked why I got my panties in a bunch about this. Based on what she has seen, the only issue she sees is the comments from the other adjuster. I then explain to her the exploits of Elka's brother(also 21) and how he likes to take his STOCK Jeep and go off roading. Everything in the file shows that this kid was off-roading and must have hit something to cause the whole in his gas tank which must have caused him to run into some bushes. In in effort to cover it up, he vandalized the car himself. There is no record of the vehicle being towed from his buddies house to his house. But the vehicle was towed from the insureds home to the shop. My manager catches on. We called the field and told them to take a look at the vehicle. My manager sends an email to the manager of the other adjuster. Should be done for the day right.....nope. I was still pissed about the other adjuster and I wanted my props for noticing the shit that other people missed. Other people that get paid much better then I do.
I called the head fraud rep for my department. I told him about all this. I told him how I got to where I was based on all a hunch and the shit the other adjuster gave me. My field rep says that he is going to come down from Simi Valley to inspect the vehicle personally. Once he does that and we need an EUO(evidence under oath) from the insured that he wants me to sit in on it. He is also going to make the VP of claims aware of the situation and what the other adjuster has done. This VP is the 3rd person down from the CEO. I have met her twice from prior fraud cases that I got to present to her. This is going to be HUGE!!!
In summation. Dont fuck with me at work. I am smarter then you. I am patient and I am an asshole when you fuck with me. I know what to say, how to say it and who to say it to to fuck your world up. This adjuster is going to be in cross hairs of the VP(most likely fired). I am going to able to present the claim to VP and make myself known to her AGAIN. Given the record that I have with finding fraud and with NO TRAINING, this is only good for me.
Today I got a comp claim for a truck that had been vandalized. It came as a 2nd sell from an outside office. This adjuster that sent it to me had the file for 2 days and spoke with the insured twice during this time. No recorded statement was ever taken. Recorded statements are REQUIRED for ALL CLAIMS!!! When I got the claim and saw that there was no statement taken and then noticed the extent of the damage to the vehicle, I got pissed. According to the report, the damage to the vehicle is the windshield, entire left side has scratches, dent in the left rear quarter panel, scratches on the tailgate. I called the shop it was going to and asked if the vehicle was there. It was and told my rep to send me pictures ASAP. I emailed the first adjuster and asked them to take a recorded statement. 20 minutes later I get a response saying it was done. I reviewed the statement and it is filled with back hand comments from the claim rep. This pissed me off. The statement was complete bullshit as far as it being anywhere complete. Key points in the file at this point.....
1) Insured took the vehicle to his friends house at 8 to 9 pm saturday night and returned at 6am the following morning to notice damage.
2) Insured is a 21 year kid that JUST turned 21
3) The insured stated that he "noticed" when the vehicle was put on the tow truck that there was a hole in the gas tank.
4) Vehicle has no lift kit
I call the insured. Insured tells me that he PATCHED the hole in the gas tank so he could put gas in it to drive the vehicle. I am looking at the photos of the damaged windshield that is only being held together because of the plastic in the glass. This thing was destroyed. HOW THE FUCK DID YOU DRIVE IT?!? I ask about the scratches on the side of the vehicle. He tells me they are key marks. I am looking at the photos again and I dont see ANYTHING on the vehicle. I tell the guy I will call him back once I get the estimate and leave it at that. I call the shop again. There are scratches on the vehicle, but they are SMALL scratches that look for like bushes caused them rather then a key. None of this shit is adding up....
I reviewed the file with my manager. My manager, god love her looks at me and asked why I got my panties in a bunch about this. Based on what she has seen, the only issue she sees is the comments from the other adjuster. I then explain to her the exploits of Elka's brother(also 21) and how he likes to take his STOCK Jeep and go off roading. Everything in the file shows that this kid was off-roading and must have hit something to cause the whole in his gas tank which must have caused him to run into some bushes. In in effort to cover it up, he vandalized the car himself. There is no record of the vehicle being towed from his buddies house to his house. But the vehicle was towed from the insureds home to the shop. My manager catches on. We called the field and told them to take a look at the vehicle. My manager sends an email to the manager of the other adjuster. Should be done for the day right.....nope. I was still pissed about the other adjuster and I wanted my props for noticing the shit that other people missed. Other people that get paid much better then I do.
I called the head fraud rep for my department. I told him about all this. I told him how I got to where I was based on all a hunch and the shit the other adjuster gave me. My field rep says that he is going to come down from Simi Valley to inspect the vehicle personally. Once he does that and we need an EUO(evidence under oath) from the insured that he wants me to sit in on it. He is also going to make the VP of claims aware of the situation and what the other adjuster has done. This VP is the 3rd person down from the CEO. I have met her twice from prior fraud cases that I got to present to her. This is going to be HUGE!!!
In summation. Dont fuck with me at work. I am smarter then you. I am patient and I am an asshole when you fuck with me. I know what to say, how to say it and who to say it to to fuck your world up. This adjuster is going to be in cross hairs of the VP(most likely fired). I am going to able to present the claim to VP and make myself known to her AGAIN. Given the record that I have with finding fraud and with NO TRAINING, this is only good for me.