A False Application to Get a Lower Premium or to Make a False Claim is Always Fraud

Published: Aug. 18, 2021, 2:32 p.m.

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A Video Explaining Why This Isn\'t Fraud I Just Need to Save Money 

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https://zalma.com/blog

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Insurance fraud is not limited to fake claims. Most people don\\u2019t present  claims. The basic principle upon which insurance is based require the  many to pay small amounts so that the few can collect. If the risk is  not spread fairly among the many, all suffer.  Most businessmen would be shocked at a suggestion that they inflate a  claim. They are honest in their business dealings. They honor their  contracts and pay their bills. They seldom have insurance claims. When  they have a claim, they deal fairly and honorably with their insurer.  Paying insurance premiums hurt. The marketplace is competitive. Prices  vary from insurer to insurer. Skills vary from insurance broker to  insurance broker.  Eventually, businessmen learn how insurers set their premiums. They know  that rates are applied to modifiers like the square footage of the  structure, the payroll, or the gross receipts of the business.  A businessman, sitting with his insurance broker, asks how he can get  the lowest premium. He will often put his morality on hold when the  broker suggests that he estimate a lower amount of gross earnings. The  businessman will see nothing wrong with loping 10,000 square feet of his  50,000-square foot warehouse when applying for insurance. When called  upon to list the payroll for his workers\\u2019 compensation policy, he will  be unconcerned when he tells his broker the payroll is $200,000 less  than it actually is. It is just good business sense to reduce your  workers\\u2019 compensation premium. When his policy shows factory workers  cost more to insure than clerical, he \\u201caccidentally\\u201d reports to his  workers\\u2019 compensation insurer that ten percent of his employees are  factory workers and ninety percent are clerical, although the opposite  is true.  The Golden Tooth  A broken tooth is a tragedy to most people. To the waitress a broken  tooth was the beginning of a career.  For fifteen years she waited tables in restaurants varying from small  coffee shops to exclusive French restaurants. She saw, almost weekly, at  least one customer trying to avoid paying for a meal. They would find  flies in their soup or chunks of metal in their hamburger. Sometimes it  was the fault of the restaurant and sometimes it was blatant fraud. Some  people actually suffered injury because of inadequacies in the kitchen.  The Fraud Division, noting that she was claiming only $650 concluded  that the claim was too small to warrant the expenditure of investigative  time. No one would investigate further, or prosecute, the waitress.  Rather than take further chances, she moved to another city where she  continued in her new profession. She is probably having a fine meal in  your town tonight.     \\xa9 2021 \\u2013 Barry Zalma

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