INDICATORS OF FRAUD


Heritage Publishing, Inc. © 2013


Indicators at the Fire Scene • Building is in deteriorating condition and/or located in a deteriorating neighborhood • Fire scene investigation suggests that property/contents were heavily over-insured • Fire scene investigation reveals absence of remains of non-combustible items of scheduled property or items covered by floaters, e.g. coin or gun collections or jewelry


• Fire scene investigation reveals absence of remains of expensive items used to justify an increase over normal 50 percent contents coverage, e.g. antiques, piano or expensive stereo/video equipment


• Fire scene investigation reveals absence of remains of items of sentimental value, e.g. family Bible, family photos, trophies


• Fire scene investigation reveals absence of remains of items normally found in a home or business. The following is a sample listing of such items, most of which will be identifiable at fire scenes except in total burns - Kitchen: major appliances, minor appliances, normal food supply in refrigerator and cabinets - Living Room: television/stereo equipment, record/tape collections, organ or piano, furniture (springs will remain)


- Bedroom: guns, jewelry, clothing and toys - Basement/Garage: tools, lawn mower, bicycles, sporting equipment, e.g. golf clubs - Business/Office: office equipment and furniture, normal inventory, business records


Indicators Associated With the Loss Incident • Fire occurs at night, especially after 11 p.m. • Commercial fire occurs on holiday, weekend or when business is closed • Fire department reports fire cause is incendiary, suspicious or unknown • Fire alarm and/or sprinkler system failed to work at the time of the loss


Indicators of Burglary/Theft Fraud • Losses include total contents of business/home including items of little or no value • Losses are questionable, e.g. home stereo stolen out of car, fur coat stolen on trip to Hawaii • Losses include numerous family heirlooms • Losses include numerous appraised items and/or items of scheduled property • Extensive commercial losses occur at site where few or no security measures are in effect • No police report or an over-the-counter report in situations where police would normally investigate


Indicators Associated With the Claims Process • Insured over-documents losses with a receipt for every loss and/or receipts for older items of property


• Insured’s loss inventory differs significantly from police department’s crime report • Insured cannot provide receipts, cancelled checks or other proof of ownership for recently purchased items


• Insured provides numerous receipts for inexpensive items, but no receipts for items of significant value


• Insured provides receipt(s) with incorrect or no sales tax figures • Insured provides receipt(s) with no store logo (blank receipt) • Loss inventory indicates unusually high number of recent purchases • Insured cannot recall place and/or date of purchase for newer items of significant value • Insured indicates distress over prospect of an examination under oath • Insured cannot provide bank or credit card records for recent purchases of significant value • Insured provides receipts/invoices from same supplier that are numbered in sequence • Insured provides receipts from same supplier with sequence numbers in reverse order of purchase date


98 2013 Jacksonville Claims Association Resource Guide


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