The Sweet Little Old Lady & Fraud

Insurance Fraud is an Equal Opportunity Crime

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The Insured was 82 years old and bored. She was born shortly after the turn of the century to a wealthy family of Connecticut merchants. She had been a debutante. She lived most of her life in luxury. Now, at 82, she was a widow living alone.

The agent submitted the application, and a copy of the forged appraisal, to a Lloyd’s correspondent with whom he was familiar. The Lloyd’s correspondent forwarded the appraisal and application to a London broker who submitted it to certain underwriters at Lloyd’s. The risk seemed a good one. The appraisal was more professional than that which Underwriters had come to expect from the United States. Lloyd’s quoted a 3% rate that the insured accepted. The policy was issued.

No one asked before issuance to look at the fine arts. No one visited the Insured’s home. The agent and the insurers accepted her representations in good faith.

McCarthy was unknown. She called an appraiser she knew in New York and asked if he had ever heard of an appraiser by the name of Leo McCarthy. He replied: “Of course, a dear man, one of the finest art appraisers who ever lived.”
“Where can I find him? A friend needs to speak to him about an appraisal he did.”
“That will be difficult.”
“Why?”
“Because he died on Midway Island in 1943.”
The Insured had made only one mistake. She had used the signature of an appraiser long dead.
Underwriters instructed the adjuster to deny the claim for fraud. They further instructed the adjuster, because of the Insured’s advanced age, not to report the attempted fraud to the police or the Bureau of Fraudulent Claims.
ZALMA OPINION
Insurers must, to conduct a thorough investigation without bias, stop the criminal actions of sweet old ladies or hardened criminals equally.
If not, crime will succeed. The innocent ex-convict will lose the indemnity to which he is entitled.
The criminal grandmother will recover and everyone who buys insurance will pay more than they should.

(c) 2022 Barry Zalma & ClaimSchool, Inc.

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