Insurance Frauds Are Not Born, They Are Trained

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Wee Willy never intended to be a criminal. His ambition in life, from age three, was to be a meat cutter like his dad. Willy cruised through high school with a solid “C” average. He knew that as a meat cutter he only needed a steady hand. Literature and mathematics held no interest for him.

As a child he would visit the store where his father worked and watch sides of beef turn into chops, steaks and hamburger with rapt attention. His father, he believed, was an artist who turned ugly chunks of dead animals into beautiful and delicious food. His ambition was to be the Picasso of meat cutters.

When Willy graduated from high school his father helped him join the meat cutters local as an apprentice. He began his career at a neighborhood Piggy Wiggly market. As an apprentice Willy was ordered about by the journeyman meat cutter. The duties of an apprentice included sweeping up the cuttings, collecting the excess fat so that it could be sold to the renderer, and lifting and carrying carcasses for the journeyman.

On slow days the journeyman would let Willy practice on the giant band saw. Willy was happy. Even as an apprentice meat cutter he was doing what he always wanted to do. He was learning his trade. He also could bring a few cuts of filet mignon to his girlfriend’s father. When her father was happy with Willy, his girlfriend was even more loving.

Willy had outfitted his house from the local Goodwill store. By the time his house was rebuilt, he had a brand new house worth twice as much as when he bought it, completely furnished with new furniture from quality stores. He immediately put the house on the market and made a $100,000 profit. With the money, he traded in his car and bought a brand new Corvette, a gold and diamond ring and a Rolex President with a diamond face. He gave his old Rolex to his father.

Life was good. Willy decided to go into business for himself. He would become a builder. He attended the contractor’s license school for one day and learned enough to pass the test and become a licensed contractor. Willy was in business for himself. He really didn’t need to work. He was going to use the contractor’s license to make more money off of insurance. Any construction job he did would be paid for completely by the insurance company.

Willy’s two domestic insurers were members of the National Insurance Crime Bureau (NICB) and the ISO All Claims database; Lloyd’s was not.

When each insurer submitted their report of Willy’s robbery, the ISO and NICB advised both insurers of the other claim that appeared to be similar to their claim.Each insurer had in place a special fraud investigation unit (SIU). The SIU investigators contacted each other and found that the two claims were identical and based upon the same appraisals. Lloyd’s, through their independent investigators, also used the All Claims database and the adjusters for the three insurers shared information concerning Willy’s claim.

Within six months Willy fell off an oil tank and broke his leg in three places. Although it hurt a great deal, Willy was happy. He had workers’ compensation again and, with his disability insurance policies, his take home pay tripled.

He knew the leg would be slow to heal and he could enjoy a life of leisure paid for by all of the other stupid people who bought workers’ compensation insurance but did not benefit from it as did Willy.

(c) 2022 Barry Zalma & ClaimSchool, Inc.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He practiced law in California for more than 44 years as an insurance coverage and claims handling lawyer and more than 54 years in the insurance business. He is available at http://www.zalma.com and [email protected].

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