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The Property Claims Investigation
By Barry Zalma, Esq. CFE - August 9, 2021

Insurers are large organizations with varying levels of authority for the payment of claims. The adjuster is the representative at the loss scene. He or she must report, in writing, to superiors with the authority to pay the indemnity required unless the claim falls within the authority provided to the adjuster who will only then write a short closing report.

Writing a clear, concise, understandable and comprehensive report is an essential part of the adjuster’s job.

The Examination Under Oath as a Tool to Defeat Insurance Fraud
By Barrry Zalma, Esq. CFE - July 29, 2021

The attorney, insurance claims professional or investigator who conducts the EUO can take a role similar to the role of a prosecutor without the usual constitutional restraints controlling testimony at a deposition or trial. [Hickman v. London Assurance Corporation, 184 Cal. 524, 195 P. 45 (1920)] A false statement as to any material fact during the EUO can cause the policy to be declared void, even if the fact has no relationship to the loss.

In Claflin the false testimony concerned a witness that would not affect the amount payable under the policy but to protect his reputation for veracity. The U. S. Supreme Court found that the witness of the injury was material to the investigation and declared the policy void for fraud because he made false statements under oath.

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