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I have never blogged before so I don't really know what I am doing here, but I guess I can start off by saying that I consider myself pretty knowledgeable in regards to insurance. I have worked for an insurance company for almost 12 years total. I worked random jobs and worked as admin for our litigation department for the first four years so I got to see a lot of cool stuff. Unfortunately, at that time, I did not know much about claims handling. Then I was in auto for about six years and now property for less than a year. I should also note that I happen to excel in identifying and referring cases that may need further review through our special investigations department.

I have seen some pretty funny stuff over the years, some pretty sad stuff, and some really cool stuff. Although I cannot give enough specifics that would ever identify a specific case, there are often things that I think could be worth sharing but not worth starting a thread so I figure this would be a good place to start. I won't give out locations, or names, and may leave out or alter other details that would potentially identify the file I am referring to.

I have one specific file right now that even got the attention of the VP of claims so I figure I can start with that one. Mrs. Smith contacted me to file a claim on a Jewelry policy. I happened to notice that this was the 3rd or 4th in a matter of a couple of years, all with similar circumstances. I ended up referring it to SIU (special investigations unit) for further review because something wasn't right. Our investigator ran a pawn report for a possible suspect and found that our insured was being victimized by a care giver. The end result was that I actually filed the police report for her (which took me calling them every day for about 10 days because normally they will only take the report from the actual victim). Once I was able to convince them to not only take the report, then I had to convince them that we had enough evidence to refer it to a detective who was able to recover a couple (of a very long list) of items and is now prosecuting the suspect based on our investigation. This was a widow (military wife) who had no children, no one in the world to help her, and was very, very ill. Without me and the SIU investigator, she would never have gotten even those 2 items back. I am in the process of going through the pawn report and paying her even more money based on the findings and the descriptions of the jewelry that were much more specific that she was capable of providing. Many, many other adjusters would have paid the claim and moved on, but that is not what I did. I will fairly compensate her for her losses and the police will prosecute the person who made a victim out of an easy target.

I am off work this week, but I will try to update this periodically with stories, or even annoyances from work.
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