Question for Claims Adjusters. Fighting Saints, please help!?

Question

My car was stolen from a mall parking lot 1.5 months ago. I filed a police report, called in the claim etc... Everything seemed to be going well with the insurance company until the vehicle was recovered. As soon as it was, my claim was forwareded to the Special Investigative Unit. They requested for me to go in to give a recorded statement which I did. They also requested cellphone records that I also provided. At this point, the person handling the claim told me today that he passed on his recommendations to the home office and is waiting to hear back. He said that he would either call or send me a letter. What does this mean? I'm afraid that they are going to try to deny my claim, but I'm not sure if they have any reason to. When I seen the car, I noticed that the ignition was smashed and the interior was gone, but the tires were still on the car. Would this have been a red flag? Also, does the insurance company have to prove fraud for them to deny a claim? Thanks!

Answer 1

Relax.  This is all normal.  They just want to make sure that it is not a fraudulent claim because a lot of people have fraudulent theft claims.  There are a lot of people that set themselves up to get there car stolen so they can collect an insurance check while all along they had someone they know take the car, take a bunch of stuff out of it and hide it.  Once the claim is resolved, they get all their stuff back from the person who took the car.

Theft recoveries usually take a while to resolve so don't worry too much about it

Answer 2

I can't find it, but I think I recall a previous question you asked. The Cell phone records rings a bell in my ancient noggin.

I have to agree with Ken, I really don't think you have anything to worry about here. So far everything you have explained is standard procedure on car theft claims. This is especially true as the number of reported car thefts increases in todays tough economy.

Here is a short list of the basics on every recovered stolen car claim.

- Recorded Statement

- Theft Affidavit

- Police Report

- Vehicle Inspection

- SIU dept involvement

If they ask you for a "Statement under oath" or an "Examination under oath" then you can panic. This is totally different that a phone recorded statement. If they request one of these that is a sure sign they intend to deny the claim as they believe you presented a fraudulent claim. I don't recall any files where we denied a theft claim without a "Examination under oath" but I assume it is possible to do so.

The ignition out and tires on is not a red flag at all. If the ignition was still in that would be a red flag. You would not believe how many try to fake a stolen car and aren't smart enough to punch out the ignition cylinder.

Off subject here, but you might want to consider getting another insurance company after this is done. I've been in the claims game for almost 23 years and the only adjusters I have run across who have to get approval on their claims are trainees. The adjuster is waiting to hear back, come on. That is just poor claim service. I would suggest that on Monday you call the adjuster or the claims office and get the name & contact info for the person who is actually making the final decision. It might be a SIU rep or a claim manager, doesn't matter. You should consider calling them on Monday and calmly and professionally ask the decision maker what the decision is. With all due respect to your company, If they don't tell you Monday or Tuesday what the decision is then you should file a complaint with your Insurance Commissioners Office. Covered or not, that will get somebody to make a decision.

Good Luck

Answer 3

If the insurance company denies your claim they will provide you with a valid reason.

All claims are sent to SIU (special investigation unit) when a recovered theft is involved. They basically want to investigate and make sure you did not steal your own car. I'm not accusing but there are people out there that do it.

The recorded statement and examination of the vehicle is just part of the Theft claim procedures.

More than likely, if there IS coverage, they will call you, otherwise you will receive a denial letter in the mail.

But about your question about your tires still being on the car, that doesn't necessarily send up a red flag.

Answer 4

It means he has completed his investigation and will let you know what the decision is once it's reviewed by the bosses.

It does not mean he will deny your claim. It does not mean he will pay your claim.

It means that he has made a decision but the decision is not "official" - so it has not been told to you yet. Once the decision is official - they will tell you.