Auto Insurance Claims/Car theft

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Question
QUESTION: Hi Jane,

I'm holing you can assist me in understanding my situation a bit further.

My veichile was stolen while i was on vacation. I had lost my key while struggling with my bags i suppose as when i came back from vacation the car was not there. The car was recovered. My claims handler had called and said my claim was sent to SIU because the adjuster said the wires were "cut clean". I must mention the car is leased but not behind on payments. The SIU automatically asked for an EUO and requested phone records, ez pass records, mileage records (last oil change), the police incident report (when i already sent it to the claims handler). When i spoke to the SIU over the phone he said the EUO should take about an hour and that an EUO are normal for these kind of claims.

All of this is news to me. Im curious as to why they are requesting phone, ezpass and mileage records? What does that have to do with my car being taken? Also, is it indeed normal dor them to request an EUO for this type of claim, even before i meet the SIU?

Please enlighten me to what i should expect.

Thanks

ANSWER: Hello Maria,

It is not uncommon for a carrier to refer a claim to SIU when the keys cannot be accounted for.  However, I should add that questions on the keys should certainly not be the sole deciding factor for an investigation.  A bigger red flag would be if you were behind on payments, which you are not.

I have no idea what "the wires were "cut clean" means.  Perhaps if you could give me more detail on that, I could comment. The point is, current vehicles have anti-theft systems which utilize computer chips.  Cutting wires?  Is the adjuster saying that someone "cut the wires" to make it appear that force was used to damage the ignition of an anti-theft system?

OK, so maybe someone did cut the wires.  I'm not sure what that has to do with you.  The company would have to prove that you cut the wires in an effort to commit insurance fraud.

As to the EUO, the company has the right to ask you to appear.  Your policy mandates it. You are also required to bring whatever they request.  On the ezpass, it would appear that they are trying to determine where someone might have driven the vehicle after the theft.  If they could prove that was you, well then you would have a problem.  But how on earth would they prove that?  If the vehicle was stolen with the ezpass, anyone could have been driving it.  So that alone proves nothing.  

As for cell phone, they are fishing, though this is not uncommon.


So here's the point.  You MUST appear for the EUO.  If you do not, they will deny your claim. and they have the right to do that under those circumstances.  Assess the situation.  If you believe they are actually trying to harm you, if your gut tells you that this investigation is not fair and impartial (as it must be), then you have a right to take an attorney with you.  Now bear in mind he has no speaking part.  And he cannot tell you to leave (because then they would deny your claim), but he does have the right to be there to protect you in case they do deny your claim for insurance fraud.  

Insurance companies do bad things to avoid claim payments.  I'm not saying this is the case here, but you do need to protect yourself if you feel you are being unfairly targeted.

If you do not have those vibes, then simply go to the EUO, bring what they ask for, and testify truthfully.  You should be OK.

Oh, and one other thing.  Insurance companies do not solve crimes.  They need to make a claims decision completely independently of a police investigation.  The insurance company's only concern is whether or not you had anything to do with the theft, and if they think you did, then they must be able to prove that.  They CANNOT refuse to pay your claim because the police haven't figured out the criminal case.  If this happens to you, then I would suggest you would need an attorney to intervene and demand payment.

Regards,
Jane




---------- FOLLOW-UP ----------

QUESTION: Thanks so much for the insight! I am not behind on my lease payments or have ever been lare enough for it to affect my credit report. As far as the wires being "cut clean" the theif stole my navigation system and gutted the center console.
Thats all i know being that i never actually saw inside the car after the theft. As for ezpass i have 2 cars and i never kept the ezpass in the car that was stolen so the records wont even have that car listed on the transactions. Are they trying to verify this is true?

I dont feel like im being targeted unfairly, especially since you mentioned referral to SIU is not uncommon in my situation. The insurance company and SIU has been pleasant (so far). I suppose i just needed clarity being that I've never been in this situation before, so i thank you for your transparency.

I suppose that they are asking for my airplane tickets and flight itinerary to prove i was out of country time of theft?

Thanks

ANSWER: Well now we have the criminal motive ... the theif stole my navigation system and gutted the center console."  Solving the crime is the duty of the police, not the insurance company.  I cannot think of a good reason why this would warrant a referral to SIU unless there are other things I don't know about.  

Actually in my opinion - based on what I know - you are being targeted unfairly.  However, having said that, just cooperate and give them what they want.  But my previous warning still holds.  They MAY NOT hold your payment waiting for a criminal resolution or an arrest.

Good luck.

Jane

---------- FOLLOW-UP ----------

QUESTION: I had the EUO and i decided not to hire an attorney. As opposed to what i read, the insurance company's special investigator interviewed me (not an attorney) and it was only he and i in the room along with the stenographer. The interview lasted about an hour and a half.i provided all documents requested and i get a call from my handler later that afternoon notifying me that he had spoke to the investigator and they are releasing the funds for my auto repair.

Does this mean the investigation is over?

I haven't received a letter yet stating otherwise and the EUO was earlier this week.

Answer
Hi Maria, nice to hear from you.

Yes, the investigation is complete and your claim is being paid.  And normally it is the investigator who conducts the EUO, although some companies do use attorneys.

Congratulations. Cooperation is the key, although in my opinion based on the information you provided, the so-called investigation was a complete waste of time.  Glad it worked out for you.

Jane

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Jane Pytel

Expertise

I can answer questions related to auto accidents, auto damage, auto theft claims, or personal injury claims. I am specifically suited to answer questions concerning insurance investigations and the effects of those investigations such as claim delays, claim denials, examinations under oath, or the special investigations unit. I can answer most any question that relates to proper claims investigations, or claims handling procedures and processes. I have authored several ebooks which provide claim guidance for consumers. Those books are available on Amazon Kindle: Power To Profit - will provide you with the knowledge you need to overcome the patterned obstacles that insurance companies will use to delay, devalue, or deny your valid insurance claim. The No Nonsense Guide to Accident Settlement - Teaches you how to manage your claim, how to identify the precise tactics likely to be used against you, and how you must respond.

Experience

12 years of experience with 3 major insurance companies. I hold an all lines adjusters license in Florida. I am well versed in claims handling, claims investigations, and industry standards related to both. The bulk of my experience stems from my 10 years as a police officer / detective. Building on that investigative experience, I became an SIU (Special Investigations Unit) Investigator. Accordingly, my unique expertise lies in the investigation of claims. What is necessary and related, what is not necessary and related? What constitutes a fair claims investigation? What recourse is available for consumers who suspect they are experiencing unfair claims delays? During the course of my experience, I became a certified trainer, instructing adjusters and investigators proper techniques for claims investigation and claims handling.

Education/Credentials
B.A., Communications, University of Miami 350 credit hours of intense investigative training, Miami Dade Police 80 hours of investigative training, various Federal Agencies, Miami, Fl Intensive Accident Reconstruction and Pedestrian Injury Analysis, NHTSA, National Highway Traffic Safety Agency, Oklahoma City, OK 2 weeks Auto Damage Appraisal, Winston Salem, NC Legal Principles Claim Specialist, AEI

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