There are countless “red flags” that insurers should examine to help determine if a claimant is committing address fraud, an insurance defence lawyer said Tuesday at the Canadian Association of Special Investigation Units’ (CASIU) 2018 Fraud Conference in Toronto.
Andrew Grayson, a lawyer with Toronto-based Regan Desjardins LLP, discussed how insurers can recognize and fight fraud related to accident benefits and vehicle loss claims. He provided numerous “indicators that stick out right away” that an insured may be lying about his or her address.
Here is a list of the Top 5 indicators compiled by Canadian Underwriter based on Grayson’s presentation:
- The address doesn’t fit with the rest of the person’s life – For example, a student at York University in Toronto may provide an address that is a farm. “That starts to set stuff off,” Grayson said. Or the person’s job, school and location of the accident are all near each other and don’t fit the address. Grayson said he hears a lot that an address may be the farm, for example, but the person is in Toronto Monday to Friday. “That’s five out of seven [days]. You really live at the place in Toronto.”
- Where the rest of the family lives – The insured may say after the accident they moved back in with their family, who happens to live near where the accident occurred “and that’s the real address.” They may also return to work or school after the accident.
- The person stops paying the insurance premiums – This is more of a flag for a possible staged accident.
- Everything they do after the accident is in the same city, where they probably live – For example, they get a rental car in Toronto, their rehab is in Toronto, as is their family and legal representative.
- They can’t describe the residence, such as whether the laundry is in the building. They also cannot identify nearby intersections, bank machines or gas stations. In some cases, they cannot identify the nearest highway exit (for example, London, Ont. only has three Highway 401 exits).
To help verify a claimant’s address, Grayson said insurers should use bank, credit card and cellphone records. All three can provide indications of where the person is using these services.