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  • Somedays I love my job

    AKA: Don't lie to me dumbass

    I'm just finishing up the file on this one to goto the police for fraud.

    So our insured (INS) calls us up one fine Sunday. Seems she was out at an establishment on Friday eve consuming intoxicating substances and sadly, when she and her partner left said establishment, her precious iPhone 4s was left on the table. When she noticed said phones abscence, she returned to the establishment and, noting phones lack of prescene on the table, enquired with the staff if a kindly patron had handed said phone in. Sadly, no such good samaritan had done so.

    INS then returns the next day to confirm said lack of good samaritan, then calls the next day and informs us of said loss of phone.

    Claims Handler looks at the young ladies file and notes that she had previously had a claim for said iPhone for water damage approx 3 months prior, wherein after we requested she supply a report on the damage she advises that the phone has started working again following its drying out. While this is not unusual, something about this claim rubs Claims Handler the wrong way (in particular that INS gave the same number as her contact number) and we elect to appoint an investigator to the claim.

    Investigator speaks with INS and her partner and obtains a signed release to obtain information from her telecommunications company. INS tells investigator that the phone was indeed an iPhone 4s, and that she had the number transfered to a new phone 3 days following the loss.

    Investigator then obtains from telecomunications company a records of all usage of the phone. He then notices an trio of issues with said information
    1) INS had been very clear than said phone was an iPhone 4s. The information to hand indicated that she had only ever had a Galaxy S4
    2) There are numerous text messages and phone calls on the day after the phone was lost to her partners number, along with other numbers which continue to be contacted repeatedly
    3) There was no record of this phone number being reassigned to a different phone.

    Investigator then contacts INS and requests an additional meeting in order to obtain an explanation for said inconsistancies. INS requests that claim be closed as she does not wish to pursue said indemnifaction (translation: BUSTED).

    As such it is clear that this was a (poor) attempt to obtain another phone (prehaps for partner?).

    Should I feel so awesome for busting these attempted scammers?
    How ever do they manage to breathe for themselves without having to call tech support? - Argabarga

  • #2
    Quoth TimmyHate View Post
    Should I feel so awesome for busting these attempted scammers?
    Yes. Yes, you should. And we think you are awesome, because you putting the kibosh on scams means the rest of us don't have to cover the cost.
    I don't have an attitude problem. You have a perception problem.
    My LiveJournal
    A page we can all agree with!

    Comment


    • #3
      So does this get closed or sent to the police at this point?

      Comment


      • #4
        Quoth XCashier View Post
        Yes. Yes, you should. And we think you are awesome, because you putting the kibosh on scams means the rest of us don't have to cover the cost.
        Thanks for the kind words. I've been given a lot of abuse in the past, asked how I can sleep etc so its nice to know there are people out there who 'get it'.

        Quoth Pimento View Post
        So does this get closed or sent to the police at this point?
        Depends on the case. This case I have received approval from our management commitee today to request the investigator prepare a police complaint. A lot of insurers in NZ won't prosecute - they think its enough to decline the claim and cancel policies. Our fraud team are mostly ex-cops so they have a very different view from most insurers fraud teams.

        Frankly I'm glad we prosecute - even if they dont get formally charged, they sure as hell are not going to do it again, and neither will their friends.

        Tangent Time As part of my role I've undergone extra training on fraud, and why it occurs. There is a great concept (originally by sociologist Donald Cressey) called the fraud triangle.

        Incentive/Pressure Pressure - such as a financial need, is the “motive” for committing the fraud.

        Rationalization - The person committing the fraud frequently rationalizes the fraud. Rationalizations may include, “I’ll just cover my excess (deductable) ”, “They will never miss the funds”, "I've paid so much over the years I deserve something out of it" or “everyone does it"

        Opportunity - This is a case by case thing. In many cases, they have genuine claim and just inflate it with extra items. In others, they hear of a friend who claimed for something and the opportnity is 'I have a policy'.

        Almost everyone has incentive to commit fraud. But they may lack the opportunity, or be unable to rationalise their actions.

        End Tangent
        How ever do they manage to breathe for themselves without having to call tech support? - Argabarga

        Comment


        • #5
          Quoth XCashier View Post
          Yes. Yes, you should. And we think you are awesome, because you putting the kibosh on scams means the rest of us don't have to cover the cost.
          Ditto. You're well worth your salary (or wages, or whatever). I wish there was no need for someone like you, and I wish you (plural) were all so good at your job that you never gave false positives. But there are thieves and scammers, and while they exist, you are needed.

          While I'm wishing, I want a pony. And world peace. And a free trip to Europe.
          Seshat's self-help guide:
          1. Would you rather be right, or get the result you want?
          2. If you're consistently getting results you don't want, change what you do.
          3. Deal with the situation you have now, however it occurred.
          4. Accept the consequences of your decisions.

          "All I want is a pretty girl, a decent meal, and the right to shoot lightning at fools." - Anders, Dragon Age.

          Comment


          • #6
            While I'm wishing, I want a pony. And world peace. And a free trip to Europe.



            ROFL I'm with ya!

            Comment


            • #7
              Quoth TimmyHate View Post
              Thanks for the kind words. I've been given a lot of abuse in the past, asked how I can sleep etc so its nice to know there are people out there who 'get it'.
              Some people get it, others think it's an infringement of their human rights to be asked to prove they suffered a loss. Thanks for sticking with it so long.

              Quoth TimmyHate View Post
              Depends on the case. This case I have received approval from our management commitee today to request the investigator prepare a police complaint. A lot of insurers in NZ won't prosecute - they think its enough to decline the claim and cancel policies. Our fraud team are mostly ex-cops so they have a very different view from most insurers fraud teams.
              Sadly, same in the UK. I supervised a very similar case to yours a few years back, where the phone network told us the "stolen" phone was still in use on their network, with another SIM from the same account (given to child of insured) and had not been reported stolen, which is a flat out requirement for the insurer to pay out. The insurer was of the view "Nah. We caught them, our arse is covered, we didn't pay out so no motivation."
              Likewise, the chap who claimed for loss of an expensive smartphone. We asked him to send us photos of the boxes, copy receipts, anything he had to back up ownership of the device. He sent us pics of the phone's box, which gave us a problem. Said pics were taken after the "loss" (had his claim number on a piece of paper in frame) using the phone in question. Metadata, don'cha love it? Again, no payout, no interest in pursuit from the insurers.

              Comment


              • #8
                Quoth bunrotha View Post
                Some people get it, others think it's an infringement of their human rights to be asked to prove they suffered a loss. Thanks for sticking with it so long.
                ....
                Metadata, don'cha love it? Again, no payout, no interest in pursuit from the insurers.
                Oh god yes. The "I'm the one who's been robbed why do I have to prove I owned the things I'm telling you I owned them"! Sigh

                As for metadata - absolutely love it. In the next few days I'll post the tale of the PS2....
                How ever do they manage to breathe for themselves without having to call tech support? - Argabarga

                Comment


                • #9
                  Quoth TimmyHate View Post
                  Rationalization - The person committing the fraud frequently rationalizes the fraud.
                  Rationalization. n. -- The "reasons" people fabricate as an explanation for doing something that you had no justification/real reason to do in the first place
                  "For a musician, the SNES sound engine is like using Crayola Crayons. Nobuo Uematsu used Crayola Crayons to paint the Sistine Chapel." - Jeremy Jahns (re: "Dancing Mad")
                  "The difference between an amateur and a master is that the master has failed way more times." - JoCat
                  "Thinking is difficult, therefore let the herd pronounce judgment!" ~ Carl Jung
                  "There's burning bridges, and then there's the lake just to fill it with gasoline." - Wiccy, reddit
                  "Retail is a cruel master, and could very well be the most educational time of many people's lives, in its own twisted way." - me
                  "Love keeps her in the air when she oughta fall down...tell you she's hurtin' 'fore she keens...makes her a home." - Capt. Malcolm Reynolds, "Serenity" (2005)
                  Acts of Gord – Read it, Learn it, Love it!
                  "Our psychic powers only work if the customer has a mind to read." - me

                  Comment


                  • #10
                    Quoth TimmyHate View Post
                    Should I feel so awesome for busting these attempted scammers?
                    Absolutely You're part of the reason that insurance is available at any price.
                    I'm trying to see things from your point of view, but I can't get my head that far up my keister!

                    Who is John Galt?
                    -Ayn Rand, Atlas Shrugged

                    Comment


                    • #11
                      Quoth TimmyHate View Post
                      Oh god yes. The "I'm the one who's been robbed why do I have to prove I owned the things I'm telling you I owned them"! Sigh

                      As for metadata - absolutely love it. In the next few days I'll post the tale of the PS2....
                      The flip side- we believe you did own them, however a quick glance at Fleabay suggests you (or someone with a very similar name to you living very near you) sold the bloody thing last week, so post us in the box, please... unless you're going to try and tell me the burglars went into your cupboards and took the box too!

                      Look forward to the PS2 tale...

                      Comment


                      • #12
                        Quoth TimmyHate View Post
                        Our fraud team are mostly ex-cops so they have a very different view from most insurers fraud teams.
                        That sounds like an excellent policy. I REALLY wish more business would pursue legal action against would-be scammers, especially when they have more than enough evidence to get a conviction.
                        Aliterate : A person who is capable of reading but unwilling to do so.

                        "A man who does not read has no advantage over a man who cannot" - Mark Twain

                        Comment


                        • #13
                          Quoth TimmyHate View Post
                          In the next few days I'll post the tale of the PS2....
                          Now, now... No teasing. Start typing
                          "For a musician, the SNES sound engine is like using Crayola Crayons. Nobuo Uematsu used Crayola Crayons to paint the Sistine Chapel." - Jeremy Jahns (re: "Dancing Mad")
                          "The difference between an amateur and a master is that the master has failed way more times." - JoCat
                          "Thinking is difficult, therefore let the herd pronounce judgment!" ~ Carl Jung
                          "There's burning bridges, and then there's the lake just to fill it with gasoline." - Wiccy, reddit
                          "Retail is a cruel master, and could very well be the most educational time of many people's lives, in its own twisted way." - me
                          "Love keeps her in the air when she oughta fall down...tell you she's hurtin' 'fore she keens...makes her a home." - Capt. Malcolm Reynolds, "Serenity" (2005)
                          Acts of Gord – Read it, Learn it, Love it!
                          "Our psychic powers only work if the customer has a mind to read." - me

                          Comment


                          • #14
                            Quoth EricKei View Post
                            Now, now... No teasing. Start typing
                            Ask and ye shall recieve. http://www.customerssuck.com/board/s...d.php?t=105463
                            How ever do they manage to breathe for themselves without having to call tech support? - Argabarga

                            Comment


                            • #15
                              Quoth bunrotha View Post
                              The flip side- we believe you did own them, however a quick glance at Fleabay suggests you (or someone with a very similar name to you living very near you) sold the bloody thing last week, so post us in the box, please... unless you're going to try and tell me the burglars went into your cupboards and took the box too!
                              But if they bought it more than a few months ago, what's to keep them from saying they discarded the box and packing material once they'd verified it was working? After all, a lot of people do that, so it would be a "legitimate" reason to no longer have the box.
                              Any fool can piss on the floor. It takes a talented SC to shit on the ceiling.

                              Comment

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