| "At any given moment, newspapers in dozens of | | | | end the disability claim of the farmer." |
| cities across the U.S. feature stories about | | | | |
| insurance fraud," says Tom Reitze, President | | | | In another situation, a David Morse & |
| of David Morse & Associates ( providers of | | | | Associates truck adjustor found himself at |
| third-party administrator services, field | | | | odds with the California Highway Patrol. |
| adjusting services, specialty claims | | | | After a tractor-trailer collided with a van |
| services, and fraud investigations. "Most | | | | and overturned on a Los Angeles freeway, the |
| consumers don't realize that 25 percent of | | | | CHP made a determination that the rig had |
| their insurance premiums are ultimately used | | | | been speeding. Although the adjustor knew |
| to pay fraudulent claims." | | | | that the truck had an engine governor that |
| | | | prevented it from speeding, the CHP wouldn't |
| Indeed, in San Jose, Calif., 25 people in an | | | | budge, exposing the trucking company to a |
| auto fraud ring were recently indicted for | | | | million-dollar liability suit. The relentless |
| allegedly staging and reporting two dozen | | | | adjustor duplicated the conditions with a |
| fake car accidents during a five-year period, | | | | replica truck and load, and had a CHP expert |
| bilking insurance companies out of an | | | | ride along, which convinced the CHP that the |
| estimated $400,000. David Morse & Associates | | | | truck wasn't speeding. Following his |
| and other companies provided critical | | | | suspicion the van was actually backing up on |
| information that led to the arrests and | | | | the freeway when it was hit, the adjustor |
| indictments. In Bridgeport, Conn., a woman | | | | consulted with David Morse & Associates' |
| was recently convicted of torching her home | | | | reconstruction engineer. His theory was |
| in order to collect from her homeowner's | | | | confirmed when the lab discovered the |
| insurance policy. And, in Sutton, Mass., a | | | | telltale signs of stretched filaments in the |
| man pleaded guilty to worker's compensation | | | | van's taillights, indicating that the van had |
| fraud for collecting $70,000 in disability | | | | been in reverse and the backup lights were on |
| benefits while secretly working in a | | | | at the time of impact. Because of the |
| physically demanding job. | | | | adjustor's diligence, the million-dollar |
| | | | claim was arbitrated for a relatively small |
| According to Reitze, David Morse & Associates | | | | amount. |
| is committed to combating insurance fraud, | | | | |
| which ultimately helps consumers by keeping | | | | Notes Reitze, "The adjustors at David Morse & |
| insurance premiums in check. "The premise of | | | | Associates know that doing the right thing |
| insurance is pooled risk, but when the bad | | | | also means stepping in and helping people who |
| guys bilk insurance companies, honest people | | | | are legitimately injured." When they do so, |
| suffer through higher premiums," he says. | | | | it often helps both the injured person and |
| "That's why our fraud investigation unit | | | | David Morse & Associates' insurance client. |
| prides itself in catching fraudsters in the | | | | |
| act." | | | | As an example, a truck driver was making a |
| | | | turn and didn't see a pedestrian in the |
| Reitze readily recalls any number of claims | | | | crosswalk. The truck screeched to a halt, but |
| where David Morse & Associates fraud | | | | the man was knocked backwards and struck his |
| investigators and adjustors employed dogged | | | | head on the pavement. The David Morse & |
| legwork, quick thinking, and expertise to | | | | Associates adjustor arrived on the scene |
| keep their clients from being defrauded and | | | | quickly, only to find passersby surrounding |
| help honest consumers in the process. | | | | the man trying to get him an attorney. |
| | | | Although the man refused ambulance services, |
| In one instance, a David Morse & Associates | | | | the adjustor could see that he was shaken and |
| investigator was assigned to a person | | | | concerned. The adjustor quickly came up with |
| alleging total disability who happened to | | | | a solution and drove the pedestrian to the |
| live in a rural farming community. The | | | | Emergency Room himself. Moreover, the |
| investigator was inventive in locating the | | | | adjustor arranged for the client's Safety |
| residence of the man, but when he was not at | | | | Director to pay for the $2,000 medical bill. |
| home, the investigator had to turn to | | | | The pedestrian was given a clean bill of |
| townspeople for help. The investigator was | | | | health and was pleased with the outcome and |
| told that the "disabled" claimant was | | | | attention he received. |
| building a house in a nearby town. Reitze | | | | |
| points out with pride, "Although the | | | | The corporate culture at David Morse & |
| investigator was required to videotape the | | | | Associates can be summed up by the maxim, |
| man, he found himself in the midst of fields, | | | | "doing well by doing good." With 42 branches |
| with no place to hide his vehicle. Using his | | | | in 16 states, the company values the |
| imagination, he staged a vehicle breakdown on | | | | expeditious and personalized service they |
| the side of the highway, and managed to | | | | provide to their clients. "In the process, we |
| capture video of the man bouncing around over | | | | do our part to help fight insurance fraud, |
| rough ground on a tractor and manhandling | | | | which benefits both insurance companies and |
| bales of hay. Thanks to the inventiveness of | | | | consumers," concludes Reitze. |
| the investigator, the videotape was enough to | | | | |