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Fraud Investigators: The Police Detectives of Insurance

Written by Michele Wilmonen. Posted in Definitions Last Updated: 11/17/2015

Fraud investigators are essential to the prevention of fraudulent insurance activity.

Fraud Document on an Investigators Desk

Insurance fraud is a fraud investigators main focus.

Insurance fraud is sometimes regarded as a victimless crime. This means that the crime is not directly violating the rights or endangering any particular person (victim).

This definition of insurance fraud does not exactly stand if you consider the repercussions of insurance fraud. The amount paid out to people that commit insurance fraud and the money that has to go into finding and persecuting these criminals are funneled out to all of us in increased insurance premiums.

This makes all of us victims of insurance fraud and is why fraud investigators are important to the industry and to all of us that have insurance.

What Are Fraud Investigators?

Fraud investigators work directly for insurance companies or for the state insurance commissioner’s office (or department of insurance) researching questionable insurance activity. This activity can be anything ranging from the most common fraud of fake insurance claims to premium being stolen. The concentration of a fraud investigators case can be a fellow employee of the insurance company, an agent, a claimant and even the insurance company’s own clients.

Why do we Need Fraud Investigators?

We need fraud investigators to help catch the criminals that commit insurance fraud and also to stop insurance fraud before it is too late. In the case of fraudulent claims, a fraud investigator can help prevent a fake claim from being paid out. They can also prevent too much from being paid out on an exaggerated claim.

If a fraud investigator can prevent the money from being paid out by the insurance company, the insurance company won’t have to raise premiums for the people insured with them to recoup the loss. The less that we have to pay out because of other people’s criminal activity should be good news for all of us that have to pay insurance premiums.

Fraud investigators also investigate fraud that may be happening with insurance premium. Situations like agents that are keeping premium instead of passing it on to the insurance company for their client’s coverage. They also investigate clients that lie about where they live to get cheaper insurance rates. Nothing in insurance is safe from fraud which is why insurance investigators work with just about every department of an insurance company.

A Dangerous Job

On June 7th, 2011 two fraud investigators in the state of Louisiana were killed while trying to obtain documents from an agent that was the focus of a premium fraud investigation. The agent that was under investigation, for stealing his client’s insurance premiums, shot and killed both unarmed fraud investigators before killing himself.

Being the main focus of an insurance fraud investigation is as unwelcoming as being the main suspect of a police investigation. People that find themselves in this position act out defensively and sometimes cause injury to the investigators or damage to their vehicles. People show less restraint of their bad intentions with fraud investigators than they would a police officer and unfortunately fraud investigators have to do their job unarmed… this time.

Is Car Insurance the Next Car Sales Gimmick?

Written by Michele Wilmonen. Posted in Research Last Updated: 07/24/2011

Car dealers and manufacturers try everything to get you to buy a new car, including throwing in free car insurance now.

Free Sign of Insurnace for Buying a New VehicleAt the beginning of July this year, General Motors announced a new incentive for new car buyers in the states of Oregon and Washington. For one full year they will pay your car insurance for you. Of course, as with all deals that sound too good to be true, there are terms and conditions.

It begs to ask the question though, is this offering from General Motors the start of a new kind of car buying incentive?

The Car Insurance Offer

General Motors has partnered with Met Life Home and Auto Insurance to provide this incentive to their new car buyers. The offer is available to anyone that buys a new vehicle from them between July 6, 2011 and September 6, 2011. The new vehicle has to be a 2010, 2011 or 2010 year model and has to be a Buick, Chevy, Cadillac or GMC vehicle.

The insurance will start as soon as you purchase the vehicle and will last for a full year. This is two insurance terms that you will get for free from GM. The policy through Met Life will include the following coverages and limits:

  • Bodily Injury/Property Damage Liability – 100,000/300,000/100,000
  • Personal Injury Protection – 15,000 per person (Oregon) / 10,000 per person (Washington)
  • Uninsured/Underinsured Motorist – 100,000/300,000/100,000 (Oregon Only)
  • Uninsured Motorist – 100,000/300,000/100,000 (Washington Only)
  • Comprehensive Coverage – 500 Deductible
  • Collision Coverage – 500 Deductible

(GM/Met Life Conditions)

As you can see by the insurance coverage offered, the policy is a very good one. In fact, it is better than the car insurance that most of us regularly carry on our vehicles.

Does Driving History Matter?

General Motors says that the insurance will be provided for the new vehicle that you purchase regardless of your driving or credit history. They still need this information from you so that Met Life can calculate your premium rates. That way Met Life can send General Motors the bill for them to pay your insurance.

The Free Car Insurance Conditions

You have to be a resident in the states of Oregon and Washington State to qualify for this offer.  General Motors is only offering this in these states because this is where their sales are the lowest right now. You also have to register the vehicle in and have a valid driver’s license for these states.

You do not have the option to decline the insurance offer to get a discount on the vehicle instead, this is a take it or leave it offer. If you sell or trade the new vehicle within the year of insurance coverage, you are not due a refund and you cannot transfer the coverage to a different vehicle. After one year of insurance, Met Life will automatically terminate the policy. You will have the opportunity to purchase a new policy with them or take your car insurance somewhere else.

A New Car Insurance Trend?

Is this free car insurance offering something that we are going to start seeing more in the future? You can bet that other car manufacturers are going to be watching General Motors’ earnings report for these two states with a good deal of interest. At the same time other insurance companies are going to be watching Met Life’s earnings to see if this partnership was a lucrative one for them also.

If this works well for both of the companies involved right now, this may be something we see available more often.

Jerry’s State of Regret – State Farm® Video

Written by Michele Wilmonen. Posted in Advertising, Research Last Updated: 07/21/2011

An interesting accident makes former State Farm client, Jerry, regret that he switched to a company that has no agents to help him – Video



Commercial opens with State Farm agent Jessica DeClercq answering the phone in her agency from a former client of hers, Jerry Newman. On the screen are the words “State of Regret”. We see Jerry through the windshield of a vehicle and he tells Jessica that he has a policy question. The screen shot is fast, but we see that the steering wheel of the vehicle is at an angle that just doesn’t look right.

Jessica greets Jerry and asks, “How are you doing?”

Screen changes back to Jerry and we see why that steering wheel looked a little funny in the last shot with Jerry. Jerry tells Jessica that he is “Fine” and that he has just had a little “Fender Bender”. We see that Jerry’s vehicle is nose down and the back of the car is in the air, leaning on a pole.

Jessica tells Jerry, “I’m so sorry, I would love to help, but you dropped us last month.”

Jerry responds with regret in his voice that it only took 15 minutes to switch to that “other” insurance company, but that it is now taking longer for them to respond to him.

Jessica asks Jerry, “Is your car up a pole again.”

Jerry breaks down in tears that he misses his agent Jessica, but won’t admit to crying.

Commercial ends with the words “Jerry. Jerry. Jerry. Should’ve Stayed With State Farm” on the screen and then “get to a better State”.

Announcer: “Get to a better state. State Farm”

Point of the Commercial

The whole 15 minutes comment gives away that the other insurance company is GEICO. State Farm is trying to make the point that you may save money in 15 minutes by switching to GEICO, but you aren’t going to have a local agent to help you. When it comes to when you really need help, you are going to regret leaving your agent.

What They Want you to Do

If you are still with State Farm, they don’t want you to leave for the possibly cheaper rates at GEICO. If you have already left State Farm, they are trying to get you to come back by showing you how much you are going to miss your agent when you really need them.

My Opinion

Okay, in all the years that I worked in insurance claims, I have never heard of a person doing this. Whoever came up with the idea for this claim has a great imagination.

I also like the creativity and playing the “no agent to help you when you buy insurance directly from the company” card angle that State Farm took. Thumbs Up.

American Family Insurance: Do They Have an Accident Forgiveness Program?

Written by Michele Wilmonen. Posted in Research Last Updated: 07/26/2011

American Family Insurance has no accident forgiveness program that is promoted at this time.

If you are in an accident and are insured with American Family Insurance they will charge you a surcharge depending on who is at fault for the accident. It doesn’t matter if this is your first accident or not, they do not forgive the first or any other accident at this time.

The amount that American Family Insurance pays out, the type of accident and also any additional traffic violations that you are charged with will determine the amount of the premium increase you will see. There is no across the board percentage increase on your premium if you have an accident.

If you have any questions about the claims process with American Family and how it may affect your premium with them, it is best to contact your agent.

Do GEICO Woodchucks Chuck Wood?

Written by Michele Wilmonen. Posted in Advertising, Research Last Updated: 07/20/2011

GEICO video provides their own wood chucking proof that you really can save on your car insurance with them in 15 minutes.



The commercial starts with a GEICO spokesperson asking, “Could switching to GEICO really save you 15% or more on car insurance?” After a pause, he then asks the question, “Do woodchucks chuck wood?” 

The scene switches to two woodchucks throwing (chucking) wood into a pond in front of a cabin. The owner of the cabin drives across a nearby bridge and yells at the woodchucks to, “…quit chucking my wood.”

After one last toss by one of the woodchucks they run off into the woods and the commercial closes with the GEICO logo over the cabin scene and the announcer stating, “GEICO, 15 minutes could save you 15% or more on car insurance.”

Point of the Commercial

GEICO is making the point to the viewers that you really can save 15% or more on car insurance because they just showed you that woodchucks really do chuck wood. We all know that in real life woodchucks don’t do this, at least where I live they don’t.

Actually, I had no idea what a woodchuck was and I had to look it up.  Turns out we do have woodchucks where I live, but we call them marmots or groundhogs in the Pacific Northwest. Regardless, they still don’t chuck wood, unless they are in a GEICO commercial.

What the Insurance Company Wants You to Do

Obviously, GEICO wants you to give them 15 minutes of your time to see if you can save 15% or more on your insurance premium by switching to them from your current carrier. They tell you right out what they want from you.

But, there is also a less obvious underlying reason that GEICO is aiming for with this ad.

When you watch this ad, it makes you laugh. It has nothing to do with car insurance, but it is ridiculously funny and you tell other people about it. They then see it and tell other people about it. GEICO has just succeeded in getting people to talk about the commercial and get their name passed around by word of mouth.

This seems to be the real motivation of what they want you to do.  In fact, if you watch the commercial again, they make no mention of you calling or clicking on their website to get your quote. The only contact information that they provide is a quick shot of their company logo with underneath it.

My Opinion

I love this commercial. It is hilarious and for me it still hasn’t gotten old even though I have now watched it close to 10 times in a row in the last 20 minutes. Thumbs Up.

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Car Insurance Guidebook Unravels the Car Insurance Mystery

Unless you work in the car insurance industry, the topic is probably a mystery to you. The words deductible, comprehensive, collision, liability, premium, loss of use and bodily injury are all gibberish when they reach your ears.

Unfortunately, insurance is something that you are required to have by law if you want to drive. Because of how confusing it is many people go around in almost an insurance daze while they get car insurance quotes from the auto insurance companies that they have heard of. In reality, they are completely lost as to what they are actually buying.

Instead of looking at what each insurance company offers in the terms of protection for both themselves and their car, they are instead looking for cheap car insurance. Finding the cheapest car insurance coverage makes having to buy the required product all that much less painful, but misses the whole point of having insurance.

Learning about insurance through your insurance agent or websites like Car Insurance Guidebook will give you the upper hand when you looking for car insurance. You can take your knowledge and not only find the best price for insurance, you can use it to find really great insurance to protect you and your assets. Then you aren’t stuck settling for just average car insurance that can hurt you financially if you ever need it because there isn’t enough protection.

For example, when looking for insurance the car insurance rates are just the first of many factors that need to be taken into account when you are shopping around for car insurance. You also need to take into account the type of vehicle that you are driving. Many people don’t know this.

Are you driving around a vehicle that is a new sedan and can be protected under any blanket insurance policy? Or do you have an old car that you fixed up that needs special protection and could be better covered under classic car insurance?

Don’t just assume that when you compare car insurance that it will be a one-size-fits-all policy. This is where the insurance knowledge will come in handy; you will know what you need to protect yourself and your vehicle.

You will understand what your insurance agent is talking about when they use insurance terms and you will actually be able to make an informed decision. This is much better for you instead of the “nod and smile” approach people take in their insurance agent’s office.

Also just like your life changes your insurance needs will change. This year you may just need to learn about the best deductible to have. Next year you may need to educate yourself on car insurance for young drivers. As the years pass, motorcycle insurance may be something you will need to know.

Many wise people say that you never stop learning, so take their advice and educate yourself on the insurance that you spend a lot of money on and can’t get away with not having.