http://www.glassbytes.com/2015/10/arizona-company-owner-arrested-for-allegedly-submitting-false-glass-claims/


If only the magazine would be as aggressive with all types of fraud.

there are our previous customers the network would not allow to do their work,
sounds like fraud to me.

there are short pays that also sound like fraud to me, it is a two way street.

Funny the article infers that fraud is when there is a charge for a replacement that
has not been done.

"In Arizona, it is a class 6 felony for an automotive glass repair representative or salesperson to knowingly submit a false claim to an insurance company if the services were not provided."
What about when services are provided and not paid or partially paid for?

Makes a person wonder how something so lop sided got written into a law in a county where
we are all equal under the law? Anybody seen the 14th amendment?

I believe you are right but it cannot excuse his alleged acts. Your question should be asked to the Arizona department of insurance and their fraud section .

If there was an assignment of proceeds, the shop can act as the insured in those calls.

Even if the shop has an assignment, it does not mean that they can impersonate someone else. They must identify themselves as who they really are and then mention the assignment. However, that doesn't mean that the TPA or insurance company rep has to believe the caller until they have the signed assignment in hand.

Incidentally, most policies require written notices of loss.

Doing what he did gives us all a black eye.....

Few know that most policies require written notice of loss. Kudos.

How many times has anyone seen that happen, unless the customer has chosen a "non approved" shop?

How many other "policy provisions" are "selectively" enforced?

I, personally, would like to see this discussion stay focused on the original issues mentioned above, specifically, why fraud seems to be a one way street?

I will say this, before contacting any state insurance fraud unit or DOI, one should read and know that state's insurance, and general, fraud laws, including what the definitions of fraud are, WHO the laws applies to, and what the penalties are. THEN, one is in position to know whether the authorities are speaking "the truth" when answering questions, or sidestepping the questions and answers completely.

I say this because I have personally witnessed such "selective" enforcement, even when the laws are written in plain, simple, black and white language, that any person can understand easily. Yet, "interpretations" vary when the insurer is the one allegedly committing the fraud.

So if you go, take a big hammer, have your ducks in a row, and tie a rope around your waist so you aren't sent down multiple bunny trails to deliberately confuse you and make you go away, your questions unanswered.

Also beware of the "We had no idea this was going on!! We'll get right on this and get back to you!" responses, that never happen due to "alleged" or "suspected" influence peddling.

JMHNLO

I will risk getting bombarded here, but fraud in our industry really is a one way street and we are trying to compare apples to oranges.

None of the issues we face from the insurance companies would ever constitute fraud. However I do believe we face serious issues of unfair claims settlement practices, steering, and plain old short payments. All of these issues are civil in nature, at least in az. Frauds are a criminal issue.

If a company whether it be an insurance co or a fleet customer damages my company civily by not paying me, short paying me or in some other way I will pursue it through the means available to me.

The insurance companies pursued this individual with the means they had available to stop damage to them. It just happened to be using the criminal system.