I have been involved in a variety of fraud investigations in my time so I can give a bit of customer feedback. Over the years you get a good idea as to whether you are looking at a good investigation or a bad one. Generally the key is precision.
For me to suggest to investigators how to go about their business therefore seems to be a bit of a fraud. do, however, run fraud cases.
As part of that exercise I analyse investigations. I then use the data to run a case. I am therefore a customer and can give a bit of customer feedback. Over the years you get a good idea as to whether you are looking at a good investigation or a bad one. Generally the key is precision.
Before I go on I’d like to stress that in my view the primary role of an insurance company is to honor and pay valid claims. I also remind everyone that it amounts to professional misconduct for a solicitor to suggest a claim can be denied upon the basis of fraud unless the allegation can be proven.
With a good investigation you can, in general, at some crucial point in time, say to a judge: “Your Honour, what was said by witness X is plainly untrue and cannot be accepted as …””
The reason I then trot out needs to be solid. I am accusing someone, in open court, of not telling the truth. If I get it right I destroy their credibility. If I get it wrong I destroy both my own credibility and that of my client.
- The stakes are high and there is no second chance. Today I propose to:
- Do a quick recap on onus – who has to prove what in an insurance claim
- Do a quick recap on Fraud – what is it?
- Discuss Investigation
- Look at some examples
- Let you talk about current issues in an open context
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