by Brian Tenzer, Esq.
A vast majority of Public Adjustors (PAs) are honest and provide a valuable service assisting insured individuals through the claims process. However, I believe claims adjusters must do a number of things to ensure honest and accurate claims:
- Insist on speaking directly to the insured. Often, the insured is unaware a PA is submitting a fraudulent claim. When the insured and PA scheme together, the insured often tries to removes him/herself from the investigation and let the more experienced PA do the “dirty work.” Direct contact with the insured gives adjusters a better opportunity to evaluate the insured’s story.
- Review the policy to determine if it’s possible to exclude the PA from the Examination Under Oath (EUO). To an extent, the EUO reveals your “game plan,” which you don’t want to share with a fraudulent PA.
- If you suspect fraud, immediately hire an attorney or someone else to serve as your fraud investigator. Often, golden opportunities are lost – important questions not asked in EUOs; expert inspections not conducted until it’s too late; and inconsistencies in statements and documentation not explored in a timely manner.
Again, most PAs are truthful, hardworking professionals, but a few bad apples are helping contribute to soaring insurance rates. Claims adjusters often are the first line of defense in weeding out possible fraud.
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