Can Insurance Adjusters Be Guilty Of Insurance Fraud?

One of the scariest parts of filing a claim with your insurance adjuster is what happens when they don’t believe your side of the story. What if you were in a car accident for which you were not at fault — but the police have questions and your insurance adjuster has already decided that you lied? That’s where lawyers become important to the process.

But it’s also not the scariest part of dealing with insurance agents. What happens when those insurance investigators know exactly who was at fault for the aforementioned accident — but blame you anyway? After all, they know the police might be on their side.

This is the type of situation where insurance fraud — typically something we believe individuals commit against insurance companies for their own benefit — transitions into something more sinister. Yes, your own insurance adjusters are sometimes guilty of insurance fraud when they try to defraud you out of money owed.

One recent court case decided against an insurance agency when its CFO pleaded guilty to multiple charges of embezzlement. David G. Pietro was sentenced to two years probation, community service, restitution, and a revoked license. He collected premiums from clients but never provided the monies to the company, which left the clients on the hook a second time and without coverage. This is a common example of insurance fraud where the insurer is the guilty party.

What should you do to prevent falling victim to such tactics?

First, make sure you document everything. Why did you need to file a claim? How much was the claim worth? Always keep the receipts! When no receipt is delivered, request one. If a receipt is denied, it’s time to find a lawyer. This individual will help you continue communicating with the guilty insurance adjusters, build a case, and contact the authorities when necessary. This type of situation can happen to anyone. Don’t let it happen to you!