Validity of accidents should be questioned where SABS claims are involved

An insurance company can put itself in a much better position if it questions the validity of an accident when Statutory Accident Benefit Schedule (SABS) claims are involved, John Desjardins, partner, Regan Desjardins, told delegates at the Toronto Fraud Forum on Oct. 2.
Look at the different pieces of information available, especially reports and notes contained in the file, for any inconsistencies.
Log notes in the file all have time elements that can call into question the insureds claim of events, while insurance companies record the initial contact, which can provide a wealth of information not only the time of the contact, but whether the person calling in was even the insured.
Tow truck invoices contain time, location and damage to the vehicle and often the tow truck driver makes a valuable witness.
The collision reporting centre will have photos, diagrams, time frames, location of damage on the vehicle, passenger lists (which comes in handy during car-stuffing cases) and the name of the third party insurer or adjuster.
A police report processed on the scene will include any charges listed (which an insured might deny or fail to disclose in a SABS claim), Desjardins added.
Preserve the evidence to ensure that the vehicle can be inspected and reassessed. Get in touch with the third party insurer to work on accident reconstruction. Contact any potential witnesses, including third party drivers, who might be able to comment on behaviour and number of people in the car. Interview the owner of the vehicle, even if it is not the driver of the vehicle, he noted.
When speaking to the claimant, ask questions about the night before, or earlier in the morning before the accident. Most claimants are only prepared for the five minutes before the accident and are not prepared for increased scrutiny and inconsistencies may come to fruition, he added.
When examining evidence, “if it doesn’t make sense to you . . . probably won’t make sense to a judge or an arbitrator either,” Desjardins said.