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The Golden Tooth  

https://zalma.com/blog

Barry Zalma, Esq., CFE presents videos so you can learn how insurance  fraud is perpetrated and what is necessary to deter or defeat insurance  fraud.  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. S

he 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.  One Sunday afternoon, sitting in front of her television munching on a  dish full of almonds, her right upper incisor snapped and she found half  a tooth in her hand. No blood and no pain, just half a tooth in her  hand and a jagged piece in her mouth.  If she were not creative, if she had not been frustrated at seeing her  employers successfully defrauded over the years, she would have made an  appointment with her dentist and had the tooth capped. The waitress was  very creative. She saw the broken tooth as the start of a profit making  venture. Since she had Sunday evening off and no specific plan, the  waitress made a reservation for one at a fine restaurant where she had  once worked. 

She took with her to the restaurant, safely tucked in a  compartment of her purse, the broken tooth and a small piece of steel  that she cut from the top of a coffee can.  Her efforts at insurance fraud were successful. However, she became  greedy and eventually, her name and broken tooth story began to appear  in insurance company databases. When she presented a claim to a  restaurant insured by the same company, who had insured the last two  restaurants to whom she had presented a claim, the adjuster refused to  pay her. He reported to the fraud division of the insurance department  in his state the fact that the waitress was apparently making fraudulent  claims for the same tooth to various restaurants. 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.  

(c) 2022 Barry Zalma & ClaimSchool, Inc.