Insurance Companies Are Paying Cops To Investigate Their Own Customers

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This Person Wanted An Insurance Payment. They Got Arrested Instead. They're Not Alone.

In April 2006, a massive storm damaged hundreds of homes in Indiana, with hailstones the size of baseballs smashing roof shingles, cracking windows, denting cars, and leaving a mountain of costly insurance claims in its wake.

But that tension erupted in the fall of 2008, when a group of cops surrounded him on his way to an arbitration hearing related to a disputed claim from the epic hailstorm. The police arrested Radcliff, threw him in jail, and told him he was being charged with 14 felonies, including insurance fraud, corrupt business influence, and criminal mischief.

“Some of the negative press that has been occurring in Indy has been generated by...questionable contractors in efforts to put pressure on us to simply pay,”show. “A good, positive story to indirectly expose some of these practices and help protect consumers would go a long way to helping change the public’s attitudes and perceptions.”

Some homeowners complained to the Indiana Department of Insurance about the intimidation tactics. One saidas well unless he accused Radcliff of vandalism.Despite the complaints, Tom Cockerill, an investigator for the insurer, took the allegations to the National Insurance Crime Bureau, an industry-funded nonprofit that acts as a liaison between insurers and law enforcement. But Cockerilland customer statements that contradicted the company’s allegations.

The mood was jovial. Enjoying drinks and catered meals, insurance company investigators and police detectives greeted one another as old friends, swapping war stories and trading the latest tips and tricks from the field. Vendors pitched surveillance services and social media monitoring software that allow investigators to covertly track policyholders suspected of fraud.

Those law enforcement officials collected $5.6 million in restitution from people accused of insurance fraud in 2018, money that went back to the insurance companies. According to the IFPA’s annual report, the most commonly investigated cases don’t involve sophisticated organized crime rings, but individual policyholders ages 18 to 34 with no prior criminal record.

Donahue, who previously worked as an investigator for several insurers, said the funding model doesn’t pose a conflict of interest. “The referrals are reviewed by seasoned professional prosecutors who accept or deny referrals based on the evidence provided,” he said. “I have not seen any evidence of criminal charges bolstering a company’s decision not to pay a claim or serve as a disincentive for legitimate claims to be filed.

His salary of $93,549, as well as those of the police officers assigned to work on insurance fraud, was entirely covered by grants from the Pennsylvania Insurance Fraud Prevention Authority. Last year, the money that the insurance board gave Allegheny County to go after insurance fraud came to $728,202, all told, and over the past decade his office handled more such cases than almost any other agency in the state.

Hart, a 59-year-old bus driver, had been rear-ended on the way to work more than a year earlier, an accident that no one held to be his fault. But the other driver’s auto insurer, Progressive, took issue with his claim that his wrist had been seriously injured in the crash. Following the accident, the other driver had assaulted Hart, according to a police report.

But Hart was confident. He had no criminal record and figured if he wasn’t a liar, the law would be on his side. He stubbornly refused to take the deal, and started working more overtime to cover his mounting legal bills. Despite the courtroom victory, his own insurer, Liberty Mutual, dropped his coverage. He said he’s been unable to convince Pennsylvania’s insurance regulator or other authorities to investigate what happened to him. Liberty Mutual declined to comment on the matter.

“They’re saying, ‘We have a right to be wrong, and if we’re wrong you can’t sue us,’” said Amy Bach, the executive director of United Policyholders, a consumer group that advocates for insurance policyholders. “You know how you have fishing nets for tuna and it also catches dolphins in the same net? If the system is too aggressively or too broadly applied, it hurts people who did not commit fraud but can’t muster the resources to defend themselves against the juggernaut of a big corporation.

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So looks like State Farm’s not a good neighbor and is not there for us

Is it really surprising though?

WTAF?

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