Shooting Fish in a Barrel

Much of my professional career has involved the investigation of insurance claims. And I can tell you the life of an accident benefits investigator is never boring. Here is a small sampling of the variety of different claims you can expect to see in this line of business on any given day.

Now you see it… Now you don’t

In one assignment, I took statements from three claimants at the office of their lawyer in Toronto.

I followed the same procedure with each claimant. The claimant and I were left alone in an office. I wrote each statement by hand. The claimant and I read the statement together and I made sure he agreed with every word.

I then gave the unsigned statement to the law clerk. She advised me she had insufficient time to have the claimant sign the statement that day. I had to leave my original statements with her, but took photocopies with me.

When I received the signed statements, the originals had been materially altered. Here are just a few examples:The phrase “Unless I’m stiff, I don’t need help getting dressed and undressed” had been changed to: “Unless I’m stiff, I need help getting dressed and undressed.”  (Huh?)

The alleged service provider of one claimant was his girlfriend, Amy. The sentence “Amy did some cooking for me before the accident” in the original statement was simply crossed out in the signed statement.

Again with respect to Amy, the original statement read: “Our agreement is I’ll pay her if we get anything from insurance, if not, then I won’t.” The words “if not, then I won’t” were crossed out. “We have no agreement on hourly rate” was changed to: “We have an agreement on hourly rate, $100/week.”

All three claimants gave me the wrong name for the rehab clinic where they were allegedly receiving treatment. One claimant gave me the wrong name six times. In the revised version of the statements, the name of the clinic listed on the treatment plans had been substituted for the names that had been given to me.

I was told, “I am not still going to the clinic.”  In the revised version, the word “not” was crossed out.

One claimant told me his friend Jamal was his service provider and “in the month of September, he would have worked about eight hours for me.”  The number “8” was changed to “48” in the signed statement. (Did they think I wouldn’t notice?)

To top it all off, when I interviewed the third-party driver, he told me there were only two men in the other car, not three.

The Loud, Annoying Interloper

In this assignment, I was retained to take statements from a driver and passenger. A man identifying himself as their paralegal called the adjuster. I spoke to the self-described ‘paralegal’ and it was obvious he was an imposter. When I called the real paralegal, his assistant told me the imposter was the “agent” who had brought the clients to their office in the first place. The imposter then apparently created a major disturbance at the paralegal’s office.

The claimants thus found themselves without a legal rep and they agreed to meet with me at my office to provide statements. I specified I would take a statement first from the driver and then immediately after from the passenger.

The driver’s statement proceeded slowly because he wouldn’t give me a straight answer.  He told me he had had the same family doctor for 25 years, but he did not want the insurer to contact his doctor because his doctor knew nothing about this accident. He asked for a five-minute break and left for 20 minutes. Shortly after he returned, there was a commotion in the waiting room. The imposter had turned up at our office, shouting and cursing. He said the statement was taking too long and hustled both of the claimants out of the office. He refused to give me his name.

The adjuster insisted the claimants provide statements so we rescheduled the date.

We finished the driver’s statement. I explained I would not be giving them copies of their statements until they had both signed their statements. He refused to sign it until he could take a copy with him and he then left the office.

The passenger was late, so I checked for him outside. The two claimants were huddled together talking around the side of the building; when they saw me, they scattered.

I invited the passenger, who looked like a deer in the headlights, into my office. About an hour into his statement, the driver re-appeared in my office, allegedly to discuss a transportation issue. He started talking in Farsi to the passenger. I told him to stop doing that because I could not understand what they were saying. He did it again and I asked him to leave.

I resumed the passenger’s statement. About half an hour later, our receptionist – not the same one who had been working on the day of the last aborted statement – came in and said a man in the waiting room needed to give the claimant a key. The passenger left my office. When I checked for him in our waiting room, he was gone.

I walked down the hall and saw the passenger and the imposter huddled in an alcove. The imposter was doing all of the talking. It startled them when they saw me. The imposter asked for 10 minutes alone with the passenger. I refused and ordered him out of the building. He left, but not before calling me the “B” word. We finished the passenger’s statement. He signed it and left. I made a copy of the signed statement and also a copy of the unsigned statement of the driver.

Moments later, the driver returned and said he was ready to sign his statement. He read it over and said that he wanted to make some changes, small changes, like the street name where the accident had occurred. I allowed him to make any changes he wished. He signed the statement, took a copy with him and left.

As you might imagine, there were vast discrepancies between the statements of the two claimants and between their statements and the information contained in the Collision Reporting Centre report.

And the Academy Award goes to…

In this Oscar-winning performance, I was taking statements in the home of the claimants.  Their paralegal invited me to sit on the floor and to use the coffee table as my work surface, because the claimants were so injured they could only sit in one particular stuffed chair in the living room. They moaned and sighed and put on quite a performance, apparently unaware that surveillance had been conducted on them for several days before the accident. This same surveillance showed them doing all of the activities they claimed to be unable to do now.

How sweet it is.