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Editor’s Note: This month’s winning entry is unusual because the writer has requested to remain anonymous. “I am not asking for personal recognition. What I do ask is that The John Cooke Fraud Report gets a message out to companies: good investigators will often go that extra mile because they take pride in doing an outstanding job and getting to the very bottom of a case – not because of an hour building motivation.
Because the following is a live investigation, names and facts have been slightly altered.
A MASSACHUSETTS TALE
The policyholder was claiming the theft of his 1992 Mercedes Benz 300S. The policy was a recent issue and there were many questions that needed answering. The exposure was 35-G. The company called me, Joe Thursday. Thursday’s my name, investigating’s my game.
“The usual, Joe,” ordered the adjuster. I knew the phrase well. It meant that I should keep my bill in the three figure range.
I had only the accord form and a copy of the insurance policy and application. Checked the address of the lien holder – it was a house. Found out who owned the house and made note of the three expensive cars in the driveway.
Checked county records on the lien holder as well as any business registered to the insured. Next got a copy of the original police report and interviewed the auto theft detective.
Followed up on all information contained in the police report. Among other things, I discovered that the play the insured claimed to be attending when his car was allegedly stolen from the theater parking lot, had been canceled due to adverse weather conditions on the particular night in question.
Drove to the claimant’s home address shown on the policy. He lived in a three-by-five inch drop box. Small, but clean.
Checked out the “wife,” and found out she was the claimant’s sister. Found that relationship to be curious because we don’t do things like that in Massachusetts…
The company adjuster called in information that the policyholder was terminally ill with AIDS and wanted to “settle fast – before I die.” He’d agreed to accept 80 cents on the dollar for a rapid settlement. Checked all local hospitals and could not substantiate any treatment at all, AIDS related or otherwise, under any of the claimant’s various names, during the past three years.
Spoke to insurance agent. Located current address of sister/wife and all business endeavors registered to her and claimant.
Checked them all out, recording partnerships, etc. Completed flow-chart of people, claims, companies, cars, dollars, etc. Found 13 insurance companies involved, 16 cars and eight people. Computed that previously paid claims on this gang amounted to over a million dollars.
Discovered many other crimes: check kiting, counterfeiting, forgery, parking in no-parking zones, etc.
Visited all addresses listed for eight individuals and made videotape of homes, cars and people coming/going. Obtained DOBs, D/L numbers, VINs and a bunch more.
Completed full synopsis, a total wrap of case suitable for full prosecution. I was proud, so proud.
Totaled my investigative time sheet. Oh oh – over 100 hours. Guess I got carried away. Quartered the bill to $1200 and turned in a 23-page report. “Little bit high, don’t you think, Joe?” said the adjuster.
Company saved $35 thousand. The DA is going ahead with full prosecution – they took it because the 23-page report represented a full wrap of the case. I’ve been slashed from the company’s approved list because of high billings. I’ve changed my name.
“Hello, my name is Joe Chump and I’m a private investigator…”
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