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I Did It
\\n\\nBarry Zalma, Esq., CFE presents videos so you can learn how insurance fraud is perpetrated and what is necessary to deter or defeat insurance fraud. Arson for Profit Admitted One of my investigators met with the property manager of an Insured to start the investigation of a fire claim believed to be arson. Since he was just starting his investigation with a walk through the burned-out shell the investigator was making conversation with the property manager.
\\n\\u201cSteve, how long have you managed this property?\\u201d
\\n\\u201cAbout six months.\\u201d
\\n\\u201cIt seems the fire started here on the service porch where the damage is most severe; do you know how it started?\\u201d
\\n\\u201cSure,\\u201d the manager replied with confidence and no sign of concern \\u201cI pulled a mattress off one of the beds, stacked up against the wall by the service porch and lit it with a Bic lighter. Once it was burning well, I left and drove four blocks away and came back in time to see the flames coming from the building. I heard sirens so I just drove home.\\u201d \\u201cWhy did you do that?\\u201d the investigator asked, incredulous and trying to stay calm. \\u201cThe owner asked me to burn the building and said he would pay me 10% of whatever he got from the insurance company. When are you going to pay him? I sure could use the money.\\u201d The investigator of the arson case was experienced. He knew better than to accept a confession, even one given under oath. The sworn statement was only usable to defeat the claim if it could be corroborated.
\\nWithout corroboration it was useless. He explained the need for corroboration to Steve. Arson is not Excluded - It\'s Just a Fire The Insured explained that he had recently been forced to fire Steve because his work was shoddy and some of the rent Steve collected never came to the Insured. Steve had threatened to cause harm to the insured and had almost succeeded.
\\nThe insured\\u2019s claim was paid in full. Steve, whose attempt to harm his ex-employer was blatantly stupid, he faced two felony charges: (1) Arson; and/or (2) perjury. His case was evaluated for possible prosecution and the prosecutor \\u2013 since he felt no one was harmed since the insured was paid \\u2013 refused to prosecute. The insurer has also authorized counsel to sue Steve to recover the money it paid to the Insured. After checking Steve\\u2019s lack of assets, a decision was made not to sue. ZALMA OPINION Every claims investigation requires a thorough and complete investigation.
\\nA confession, like that of Steve in this video, is not always what it seems. Corroboration was needed and when it did not exist it turned out that Steve was just trying to hurt his employer. A false denial of the claims based on Steve\'s confession would have been wrong and would have exposed the insurer to a bad faith lawsuit.
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