Fake Claims
The house really burned down. Uh...must have been a spark from a firefly. Yeah, yeah, that's the ticket. That's what cause this black smoking hole in the ground. So now, Ms. Insurance Company, please pay me the $342,000 I am owed.
Smell funny? Yeah, well, this feels like a fake claim, i.e. one in which the insurance company is being bamboozled out of their dough by a con artist. And fake claims are bad for the honest decent claimants; if big claims have to be paid, it puts upward pressure on rates for...everyone.
Related or Semi-related Video
Finance: What is a claims adjuster?3 Views
and finance Allah shmoop What is a claims adjuster Oh
Ah okay A different type of claim being adjusted Chiropractors
make a living by adjusting backs Claim adjusters Make a
living by adjusting insurance policy claims It'd be nice if
insurance just kicked in when you needed it But real
life doesn't work that way When you find yourself in
a bind that you think your insurance should cover well
you have to submit an insurance claim But when you
submitted claim try to get your hands on that insurance
money Well a claims adjuster looks it over with many
times and on You know it's not going to cover
that well The claim's adjuster does some investigating to make
sure the damage done is really wasn't fraudulent and that
it's actually covered by the insurance policy Well this process
might include some boring paperwork but could also included usually
does include in person inspections and publish pictures being taken
in video and interviews with witnesses police and property owners
and whole bunch of inspections All that kind of stuff
Well after the claim adjuster has done investigating the claims
she decides whether you get your insurance payout You know
the day you've been waiting for after paying all those
premiums for months and months and years and years She
also determines how much payment you get If anything right
she's gonna adjust your claim So just who is this
claims adjuster Really Well if a claims adjuster arrives unannounced
on the scene and starts inspecting she no doubt works
for the insurance company Naturally insurance companies like all companies
are incentivized to maximize profits for themselves Full one way
would be to minimize insurance payouts Whether that means making
sure claims a riel or just trying to hey the
bare bones payout based on the insurance policy Well it
doesn't really make a difference either way A claims adjuster
has the insurance company's interests at heart to make sure
you get your fair D .'Oh well it's smart to
employ your own claims adjuster And yes they exist in
the private market In fact if you're a homeowner in
your house was set on fire let's say unintentionally But
there's good chance you'LL have some independent claims adjusters knocking
at your door if there still is a door an
independent adjustable work on your behalf trying to maximize your
based on your insurance policy for big insurance payouts independent
claims adjusters are worth it to make sure you're not
losing out on a lot of insurance cash that you
would very much like tohave because of whatever horrible accidents
Last tragedy has befallen you since there are two parties
the insurance company and the claimant that's you And since
reality is well messy and insurance policies feature the finest
of fine print claims adjusters often find themselves in the
middle of legal payout Warfare For instance say there's a
claim from a homeowner who left the water in his
upstairs bathtub running for a week He claims it was
his cat's fault Well that's tough to prove The contractors
take a look at the damage and estimate it'LL cost
thirty four thousand dollars to fix everything Well the homeowner
had a ten thousand dollars deductible on his flood insurance
policy which means he's gotta pay ten grand of his
own cash toward the flood damage before the insurance company
will give him any money for ten grand of the
homeowners money and then twenty four grand of the insurance
company's money our homeowner would have a clean dry new
ceiling In theory the problem while the claims adjuster thinks
that contractor is quoting a vastly high fixed number is
the contractor His B F F the claims adjuster wonders
Well either way if you read the homeowners flood insurance
policies fine print on the identity of the conical of
the super piece on page four hundred seventy three you
would have found that this insurance policy only allows for
a Prius level fixed So even if it'LL cost thirty
four grand to repair everything the insurance company isn't necessarily
liable to repair everything It depends on all that fine
print in the actual insurance policy If you break your
thumb and your health insurance only covers broken fingers while
that thumbs costs they're all on you So thirty four
thousand dollar claim for the flood on the house needs
to be adjusted from a thirty four thousand dollar contractor
fix which included a Rolex too now coming from Joe
Bob Billy's contractor Shop and Repot Depot for a total
price tag in claim of sixteen thousand dollars Yep and
insurance policy claim includes the deductible So the adjusted claim
of sixteen thousand dollars means the insurance companies now upping
the latter six thousand dollars while the homeowner is still
paying the initial ten thousand dollars deductible After this claim
has been adjusted from thirty four grand to sixteen grand
The claims adjuster gets a pat on the back from
the insurance company for having saved them eighteen thousand dollars
Well the claims adjustment brings their tab from twenty four
grand to six grand in insurance payout money The homeowner
could have had his own independent insurance claim adjuster working
on his behalf to get more of that insurance money
payout Instead the homeowner more less foots most of the
bill himself For better or worse Yeah yet another small
victory for Todd's cat whiskers there Yeah we're on to 00:04:36.3 --> [endTime] you No