| "Most consumers don't realize that 25 percent of | | | | enough to end the disability claim of the farmer." |
| their insurance premiums are ultimately used to pay | | | | In another situation, a David Morse & Associates |
| fraudulent claims," says Tom Reitze, President of | | | | truck adjustor found himself at odds with the |
| David Morse & Associates ( providers of third-party | | | | California Highway Patrol. After a tractor-trailer |
| administrator services, field adjusting services, | | | | collided with a van and overturned on a Los Angeles |
| specialty claims services, and fraud investigations. | | | | freeway, the CHP made a determination that the rig |
| "Peruse the newspaper headlines in virtually any city | | | | had been speeding. Although the adjustor knew that |
| in the U.S., and you'll undoubtedly run across a story | | | | the truck had an engine governor that prevented it |
| about insurance fraud." | | | | from speeding, the CHP wouldn't budge, exposing the |
| Indeed, in San Jose, Calif., 25 people in an auto fraud | | | | trucking company to a million-dollar liability suit. The |
| ring were recently indicted for allegedly staging and | | | | relentless adjustor duplicated the conditions with a |
| reporting two dozen fake car accidents during a | | | | replica truck and load, and had a CHP expert ride |
| five-year period, bilking insurance companies out of | | | | along, which convinced the CHP that the truck wasn't |
| an estimated $400,000. David Morse & Associates | | | | speeding. Following his suspicion the van was actually |
| and other companies provided critical information that | | | | backing up on the freeway when it was hit, the |
| led to the arrests and indictments. In Bridgeport, | | | | adjustor consulted with David Morse & Associates' |
| Conn., a woman was recently convicted of torching | | | | reconstruction engineer. His theory was confirmed |
| her home in order to collect from her homeowner's | | | | when the lab discovered the telltale signs of |
| insurance policy. And, in Sutton, Mass., a man pleaded | | | | stretched filaments in the van's taillights, indicating |
| guilty to worker's compensation fraud for collecting | | | | that the van had been in reverse and the backup |
| $70,000 in disability benefits while secretly working in | | | | lights were on at the time of impact. Because of the |
| a physically demanding job. | | | | adjustor's diligence, the million-dollar claim was |
| According to Reitze, David Morse & Associates is | | | | arbitrated for a relatively small amount. |
| committed to combating insurance fraud, which | | | | Notes Reitze, "The adjustors at David Morse & |
| ultimately helps consumers by keeping insurance | | | | Associates know that doing the right thing also |
| premiums in check. "The premise of insurance is | | | | means stepping in and helping people who are |
| pooled risk, but when the bad guys bilk insurance | | | | legitimately injured." When they do so, it often helps |
| companies, honest people suffer through higher | | | | both the injured person and David Morse & |
| premiums," he says. "That's why our fraud | | | | Associates' insurance client. |
| investigation unit prides itself in catching fraudsters in | | | | As an example, a truck driver was making a turn and |
| the act." | | | | didn't see a pedestrian in the crosswalk. The truck |
| Reitze readily recalls any number of claims where | | | | screeched to a halt, but the man was knocked |
| David Morse & Associates fraud investigators and | | | | backwards and struck his head on the pavement. |
| adjustors employed dogged legwork, quick thinking, | | | | The David Morse & Associates adjustor arrived on |
| and expertise to keep their clients from being | | | | the scene quickly, only to find passersby surrounding |
| defrauded and help honest consumers in the process. | | | | the man trying to get him an attorney. Although the |
| In one instance, a David Morse & Associates | | | | man refused ambulance services, the adjustor could |
| investigator was assigned to a person alleging total | | | | see that he was shaken and concerned. The adjustor |
| disability who happened to live in a rural farming | | | | quickly came up with a solution and drove the |
| community. The investigator was inventive in locating | | | | pedestrian to the Emergency Room himself. |
| the residence of the man, but when he was not at | | | | Moreover, the adjustor arranged for the client's |
| home, the investigator had to turn to townspeople | | | | Safety Director to pay for the $2,000 medical bill. |
| for help. The investigator was told that the "disabled" | | | | The pedestrian was given a clean bill of health and |
| claimant was building a house in a nearby town. | | | | was pleased with the outcome and attention he |
| Reitze points out with pride, "Although the | | | | received. |
| investigator was required to videotape the man, he | | | | The corporate culture at David Morse & Associates |
| found himself in the midst of fields, with no place to | | | | can be summed up by the maxim, "doing well by |
| hide his vehicle. Using his imagination, he staged a | | | | doing good." With 42 branches in 16 states, the |
| vehicle breakdown on the side of the highway, and | | | | company values the expeditious and personalized |
| managed to capture video of the man bouncing | | | | service they provide to their clients. "In the process, |
| around over rough ground on a tractor and | | | | we do our part to help fight insurance fraud, which |
| manhandling bales of hay. Thanks to the | | | | benefits both insurance companies and consumers," |
| inventiveness of the investigator, the videotape was | | | | concludes Reitze. |