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

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and finance Allah shmoop What is a claims adjuster Oh

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Ah okay A different type of claim being adjusted Chiropractors

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make a living by adjusting backs Claim adjusters Make a

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living by adjusting insurance policy claims It'd be nice if

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insurance just kicked in when you needed it But real

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life doesn't work that way When you find yourself in

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a bind that you think your insurance should cover well

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you have to submit an insurance claim But when you

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submitted claim try to get your hands on that insurance

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money Well a claims adjuster looks it over with many

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times and on You know it's not going to cover

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that well The claim's adjuster does some investigating to make

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sure the damage done is really wasn't fraudulent and that

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it's actually covered by the insurance policy Well this process

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might include some boring paperwork but could also included usually

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does include in person inspections and publish pictures being taken

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in video and interviews with witnesses police and property owners

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and whole bunch of inspections All that kind of stuff

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Well after the claim adjuster has done investigating the claims

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she decides whether you get your insurance payout You know

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the day you've been waiting for after paying all those

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premiums for months and months and years and years She

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also determines how much payment you get If anything right

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she's gonna adjust your claim So just who is this

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claims adjuster Really Well if a claims adjuster arrives unannounced

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on the scene and starts inspecting she no doubt works

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for the insurance company Naturally insurance companies like all companies

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are incentivized to maximize profits for themselves Full one way

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would be to minimize insurance payouts Whether that means making

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sure claims a riel or just trying to hey the

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bare bones payout based on the insurance policy Well it

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doesn't really make a difference either way A claims adjuster

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has the insurance company's interests at heart to make sure

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you get your fair D .'Oh well it's smart to

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employ your own claims adjuster And yes they exist in

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the private market In fact if you're a homeowner in

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your house was set on fire let's say unintentionally But

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there's good chance you'LL have some independent claims adjusters knocking

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at your door if there still is a door an

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independent adjustable work on your behalf trying to maximize your

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based on your insurance policy for big insurance payouts independent

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claims adjusters are worth it to make sure you're not

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losing out on a lot of insurance cash that you

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would very much like tohave because of whatever horrible accidents

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Last tragedy has befallen you since there are two parties

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the insurance company and the claimant that's you And since

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reality is well messy and insurance policies feature the finest

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of fine print claims adjusters often find themselves in the

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middle of legal payout Warfare For instance say there's a

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claim from a homeowner who left the water in his

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upstairs bathtub running for a week He claims it was

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his cat's fault Well that's tough to prove The contractors

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take a look at the damage and estimate it'LL cost

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thirty four thousand dollars to fix everything Well the homeowner

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had a ten thousand dollars deductible on his flood insurance

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policy which means he's gotta pay ten grand of his

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own cash toward the flood damage before the insurance company

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will give him any money for ten grand of the

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homeowners money and then twenty four grand of the insurance

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company's money our homeowner would have a clean dry new

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ceiling In theory the problem while the claims adjuster thinks

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that contractor is quoting a vastly high fixed number is

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the contractor His B F F the claims adjuster wonders

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Well either way if you read the homeowners flood insurance

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policies fine print on the identity of the conical of

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the super piece on page four hundred seventy three you

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would have found that this insurance policy only allows for

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a Prius level fixed So even if it'LL cost thirty

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four grand to repair everything the insurance company isn't necessarily

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liable to repair everything It depends on all that fine

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print in the actual insurance policy If you break your

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thumb and your health insurance only covers broken fingers while

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that thumbs costs they're all on you So thirty four

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thousand dollar claim for the flood on the house needs

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to be adjusted from a thirty four thousand dollar contractor

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fix which included a Rolex too now coming from Joe

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Bob Billy's contractor Shop and Repot Depot for a total

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price tag in claim of sixteen thousand dollars Yep and

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insurance policy claim includes the deductible So the adjusted claim

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of sixteen thousand dollars means the insurance companies now upping

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the latter six thousand dollars while the homeowner is still

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paying the initial ten thousand dollars deductible After this claim

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has been adjusted from thirty four grand to sixteen grand

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The claims adjuster gets a pat on the back from

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the insurance company for having saved them eighteen thousand dollars

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Well the claims adjustment brings their tab from twenty four

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grand to six grand in insurance payout money The homeowner

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could have had his own independent insurance claim adjuster working

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on his behalf to get more of that insurance money

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payout Instead the homeowner more less foots most of the

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bill himself For better or worse Yeah yet another small

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victory for Todd's cat whiskers there Yeah we're on to 00:04:36.3 --> [endTime] you No

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