An insured is facing charges for filing an insurance claim for an accident that occurred before he bought his insurance. According to the filing, the insured obtained an insurance policy on his mother’s vehicle on a particular date. He contacted the insurance company the same date to file a claim,...
While looking through a house he and his wife had purchased, a man found about 10 pairs of signature basketball shoes that were left behind. The shoes were valuable and rare and he looked into obtaining an insurance policy on his treasure chest of sneakers, which he valued north of...
An insurer has appealed a judgement to pay a huge settlement issue that was increased recently citing lawyer fees. The original judgement was for unsafe living conditions which was not reported by the realty company managing the building to the insurance company. What do you think? If not reported, should...
A man called the police to conduct a welfare check of his wife at home. The said woman was found shot in her living room. But here’s where it gets interesting: the couple signed a life insurance policy for a vast sum of money two days before the murder. The...
An administrative body missed a glaring error when choosing a new health insurer for retired city workers that could cost a significant loss in revenue. Another insurer has sued the body citing a fixed selection process. Is the public being taken for a ride?
A woman’s mother was the insured in a policy taken out by her cousin without her knowledge. After the woman’s mother died, the cousin showed up at her door requesting for death certificates and many forms that needed filling. The daughter suspected foul play and refused. Was she right or...
A group of former basketball players were charged in a scheme to scam a league healthcare for submitting false claims. They claimed for reimbursement for medical and dental expenses for services they didn’t receive or pay for. They then pocketed the reimbursements. Insurance has claims investigations – enough said.
Dozens of employees of a private hospital have been arrested, accused of defrauding a public medical insurance scheme. The employees falsified medical records and accounts to cover operating costs, shareholder dividends and marketing expenses. Unfortunately for them, an investigation linked the crime directly to them.
A school has pressed charges against employees who were wrongfully included in an insurance plan. They did not pay any premiums but received the benefits and decided to keep it. Upon review, auditors could not find collaborating documentation endorsing the action. A little more diligence prior would have certainly helped,...
A gift shop owner decided to torch his own shop and the apartment complex above it in a bid to collect insurance. Video evidence in the investigation saw the owner coming to the shop and leaving two hours later. Fortunately, the investigators saw through the claim and framed charges. Thankfully,...
