(My analysis of "Arson Fraud and First Party Insurance Law")
Chapters one and two describe the neccessity of getting a competent team of experts together to find every possible angle to delay and deny the claim. knowing that if it's not done exactly right it could result in a multi million dollar bad faith claim from the insured. A few of the experts mentioned are, adjuster, attorney, cause investigators, private investigators, accountant, engineer, appraiser, underwriter, agent, and contractor. The examination under oath is described as the most powerful tool in Farm Bureaus arsenal. Importance is placed on doing all this with-out creating any chance of the insured sueing Farm Bureau for Vexatious Refusal. The importance of protecting Farm Bureaus claim file from the insureds lawyer is stressed, and many tactics are available to prevent the insured from aquiring it. Farm Bureau has instigated a policy of eliminating all paper work and going to strictly electronic media. This in essence will eliminate the paper trail.
Chapter six describes what farm Bureau must not do to avoid legal damage suits and/or breaking state regulations. Twenty-eight specific do nots are mentioned. These do nots are designed to allow Farm Bureau to go to the most extreme limit against the insured with-out opening Farm Bureau to the danger of being liable for the repeatedly stated bad faith, vexatious refusal, punitive damages, and State violations.
1) DO NOT, upon first notification of the claim, hesitate to provide to the insured a blank proof of loss form, along with a certified letter detailing the insured's duty under the policy to provide all the information requested. This should be accomplished within 10 days of the notification.
2) DO NOT fail to request that the insured prepare an inventory of damaged personal property showing in detail, the quantity, description, actual cash value and amount of loss and provide all supporting bills, receipts or other documents when returning the completed proof of loss .
3) DO NOT accept a proof of loss which is not completely filled out and executed by the insured or the insured's authorized agent.
4) DO NOT provide to the insured estimated values of the damaged personal property or countersign inventories .
5) DO NOT provide to the insured the company's estimates concerning the loss until and unless a complete analysis of the loss has been accomplished. Avoid quick estimates of value which may later prove inaccurate .
6) DO NOT note opinions or any other information other than room descriptions, i.e., living room, bedroom, or geographical information such as looking north or looking south, in photograph logs .
7) DO NOT exchange values or scope with the insured's public adjuster.
8) DO NOT provide the insured with advance payments. If such advances are made, they should be minimal and the insured should be required to provide documentation .
9) DO NOT hesitate in obtaining a complete copy of the underwriting file .
10) DO NOT hesitate in obtaining a complete copy of the agent's file.
11) DO NOT hesitate in checking the Property Insurance Loss Register (PILR) or other similar services for prior claims .
12) DO NOT hesitate in sending a cause and origin investigator to the scene
13) DO NOT hesitate in contacting public officials to secure any reports generated .
14) DO NOT allow the insured to interfere with the recorded statement.
15) DO NOT take a recorded statement if the insured has retained counsel without the permission of the insured's counsel.
16) DO NOT state opinions or conclusions that the insured's claim is suspicious, fraudulent, etc. to the insured or any third party .
17) DO NOT discuss the claim with the insured or the insured's agents after you have retained counsel, without first consulting with your counsel.
18) DO NOT make offers of settlement.
19) DO NOT note in the claim file that settlement should be considered prior to the completion of the investigation .
20) DO NOT note in the claim file impressions concerning the insured's dishonesty, sincerity, emotional distress, and so forth .
21) DO NOT fail to send all correspondence via certified mail and marked "Personal and Confidential.
22) DO NOT send the entire claim file to any public agency requesting it before consulting your counsel.
23) DO NOT rely upon public officials, i.e., police, fire department, prosecuting attorney or public investigators, to do your investigation .
24) DO NOT hesitate to retain experts needed for a full investigation, i.e., attorneys, cause and origin experts, accountants, appraisers, investigators, and others .
25) DO NOT reference reserves or values on normal investigation reports or diary notes .
26) DO NOT participate in interviews with the electronic and print media .
27) DO NOT describe the investigation as an "arson investigation."
28) DO NOT settle any part of a claim without a complete and final release having been executed by the insured and any other person or entity which has an insurable interest.
(will be continued as my time allows).