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FYI Express

Insurance Fraud

Insurance Fraud

E&O Prevention Strategies OverviewStrategies for Preventing Errors & Omissions: Key Features and InsightsErrors and Omissions (E&O) claims arise when a professional’s mistake or oversight causes financial harm to a client. In the insurance industry, E&O claims typically involve clients (or other parties) alleging that an agent’s error led to them being uninsured or underinsured in a loss. Such claims can result in costly lawsuits, regulatory sanctions, and reputational damage for an agency. Therefore, prevention is critical – it’s far better to avoid E&O situations than to rely on E&O insurance after the fact. The webpage in question (FYIExpress’s “E and O Prevention” page) compiles a wealth of E&O prevention strategies, including common E&O claim scenarios, practical tips, and unique insights for insurance agents. Below is a detailed report of the key prevention strategies discussed, their features, and notable insights highlighted on that page, reinforced with additional industry references and examples.
Common E&O Risk Areas and Prevention StrategiesIndustry experts have identified several common causes of E&O claims against insurance agents3. Each represents a risk area that agencies should address with specific preventive measures:
  • Failure to Place or Renew Coverage: One frequent E&O misstep is letting a policy application or renewal “fall through the cracks,” resulting in a client inadvertently uninsured. Often, this error is only discovered when a claim arises and no policy is in force. Prevention: Implement strict internal workflows to track all bindings and renewals. Use agency management system alerts or checklists to ensure no pending application or renewal is missed. For example, maintain a “no policy left behind” procedure: double-check that every renewal was either completed or declined in writing. Adhering to proper binding practices (and never exceeding your binding authority) is crucial. If a carrier will not renew a policy or cancels it, proactively secure replacement coverage well in advance of expiration. Ensuring continuous coverage for clients will help avoid lapses that lead to E&O claims.
  • Mistakes on Certificates of Insurance (COIs): Insurance certificates have become a leading source of E&O claims against agents. A common scenario is when an agent issues a certificate that omits or misstates critical information – for example, failing to note an important exclusion or listing an incorrect policy term. If the certificate holder or client relies on that document, coverage gaps can result in litigation. Prevention: Adopt a standardized procedure for issuing COIs and train staff on it. Enter only the information that is accurate and relevant to the specific project or holder. Always disclose any key exclusions or limitations: if a policy has endorsements restricting coverage (e.g. a geographic exclusion), attach those endorsement copies to the certificate. In one case, an agency could potentially have avoided a lawsuit simply by attaching the policy’s exclusion for New York City operations to the certificate. This ensures the certificate holder is not misled about coverage. In short, never let a certificate give a false sense of security – it should mirror the actual policy terms to the extent allowed. It’s also wise to send clients the full policy and encourage them to read it, so they do not rely on the certificate alone.
  • Failure to Obtain/Offer Proper Coverage: The most common cause of agent E&O claims is when a client does not have the coverage they requested or expected and suffers an uninsured loss. This often stems from an inadequate risk analysis or failing to offer an important optional coverage. For instance, an insured might assume a particular peril or higher limit was covered when it was not. Prevention: Conduct thorough needs analysis and coverage reviews for every client. Agents should act in the client’s best interest by proactively identifying exposures and recommending appropriate coverages and limits. Document your proposals and the client’s decisions: if the client declines a recommended coverage, have them sign a “coverage declined” form or email acknowledgment. This way, if a loss occurs, there is proof the coverage was offered. Additionally, leverage coverage checklists during policy placement and renewal. Consistently using checklists forces a brief discussion of all major coverage options (e.g. higher liability limits, flood insurance, umbrella policies, etc.) and records whether the client accepted or declined each. A good checklist includes optional coverages a client might need and a place for the client to initial or sign off on each item. This practice both ensures nothing important is overlooked and provides E&O protection by showing the client’s informed choices. Regular account reviews are another key tool – reaching out to clients annually to review their coverage needs not only uncovers changes (new assets, new risks) but also enhances the agency’s E&O defense. Even if many clients decline an annual review, the very act of offering it helps demonstrate the agent’s diligence. In summary, never assume existing coverage is “good enough”; always ask about changes in the client’s situation and offer to fill any gap in protection.
  • Inadequate Communication or Advice to Clients: Sometimes an agent does secure the correct policy, but miscommunication leads the client to misunderstand their coverage. If a client feels they were not given enough information or were misled about a policy, they may allege the agent failed to advise them properly. For example, using vague assurances like “you have full coverage” or failing to explain a limitation can create false expectations. Similarly, if an agent ventures into an unfamiliar line of insurance and provides flawed advice, that can trigger E&O claims1. Prevention: Educate yourself and your clients. Agents should continuously improve their technical knowledge through training and education, staying current on policy forms and exclusions. It’s wise to sell only products you fully understand – do not let the lure of a commission lead you to write a type of policy you’re not versed in. At the point of sale, take time to explain coverages, limits, and terms to the client. Clarity is crucial: for instance, explain what a term like “replacement cost” actually means in that specific policy. Encourage questions and never simply assume the client interprets terminology correctly. It’s often helpful to put things in writing – use disclaimers in proposals to clarify comparisons or limitations. For example, if a client insists on an “apples to apples” cheaper quote, include a note highlighting any differences in coverage from their current policy (so they don’t later claim ignorance). Being transparent about exclusions, limits, or fees up front builds trust and can prevent disputes. Additionally, diligently document all client communications about coverage decisions – keep notes or email confirmations of advice given and client instructions. Good documentation can both prevent confusion and serve as evidence if a claim arises. If there’s something you don’t know, don’t guess – research the answer or consult an expert rather than risk giving incorrect advice. In short, clear and honest communication, backed by documentation, is a cornerstone of E&O loss prevention.
  • Failure to Notify of Policy Cancellation or Changes: Agents who actively manage client policies must be careful with policy cancellations, non-renewals, or mid-term changes. If an agent has established a practice of notifying clients about late payments or pending cancellations, a lapse in that practice can lead to an E&O claim. For example, if an agency usually calls a client to warn of a pending cancellation for non-payment, and one time fails to do so, the client may blame the agency if the policy cancels and a loss occurs. Similarly, not advising a client of a significant coverage change upon renewal could leave them unknowingly underinsured. Prevention: Develop consistent office policies for handling cancellations and renewals. It may be prudent to always inform clients of pending cancellations (especially for non-payment) or to clearly inform them from the start that the responsibility to pay on time is theirs – but inconsistency is dangerous. Many agencies choose to send courtesy cancellation warnings; if you do, do it uniformly and record it. Always advise insureds of any coverage changes at renewal (for instance, if the new policy has a new exclusion or lower limit). That can be done via a renewal review letter or call. In the event an insurer actually cancels or non-renews a policy, help the client replace coverage promptly – preferably well before the cancellation date. If you cannot find replacement coverage, document that you warned the client of the lapse. Basically, an agent should strive never to let a client be surprised by a loss of coverage. By being proactive with client communications around renewals and cancellations, an agency can mitigate the risk that a client will later claim “I didn’t know my policy was canceled or changed.” One practical tip is to keep a central diary for all cancellations and renewals and assign staff to follow up on each. Consistency and documentation in these time-sensitive matters are key to avoiding E&O allegations.
  • Mishandling of Claims or Claim Reporting: The agent’s duty doesn’t end once a policy is sold – how you handle a client’s claim or incident can also lead to E&O exposure. A classic pitfall is an agent failing to promptly report a claim to the insurer. If a client notifies their agent of a lawsuit or loss and the agent delays or forgets to inform the carrier, coverage can be lost due to late notice. This leaves the client in a precarious position and often triggers a negligence claim against the agency. Prevention: Agencies should establish a robust claim reporting protocol. Report claims to the insurer immediately – ideally on the same day you learn of them. It’s wise to designate at least two individuals in the agency who are trained to handle incoming claims. One person can have primary responsibility and the other serves as backup when the primary is out or busy. This redundancy ensures no claim notice falls through the cracks. Also, implement a standard procedure for logging claim information and confirming that notice was sent to the appropriate carrier(s). Importantly, notify all carriers that might potentially be involved in a loss. For example, if a client has an umbrella policy in addition to primary coverage, inform both insurers of the claim to be safe. These steps can prevent scenarios like one agency faced – they failed to pass along a lawsuit to the insurer, resulting in a $1.2 million default judgment and a messy, protracted legal battle for the agent. Another tip: never assure a client “you’re definitely covered” for a claim unless you are absolutely certain. It’s better to tell the client that the claim has been reported and coverage will depend on the policy terms. Misrepresenting coverage at claim time can create liability if the client relies on your statement. In summary, treat claim notices with urgency and thoroughness. By having clear internal procedures (multiple trained staff, logs, and follow-ups) for claims handling, an agency can greatly reduce E&O risk during the claims process.
General Best Practices: Across all these areas, a few common themes emerge: the importance of organization, documentation, and communication. Many E&O issues can be headed off by **running the agency with high professional standards and “common-sense” practices. This means instituting consistent procedures (for applications, policy checking, certificate issuance, renewals, claims, etc.) and holding staff accountable to follow them. Thorough documentation forms a defensive shield: keep records of what coverage was offered, what advice was given, and what the client decided. Written records can both prevent misunderstandings and provide evidence if a claim arises. Good communication – with clients, carriers, and even within the agency team – is likewise fundamental. Frequent, proactive client communication (policy reviews, check-in calls or newsletters) helps build trust and can even “reduce the likelihood of litigation” by keeping clients satisfied and informed. In essence, E&O prevention isn’t a one-time task but an ongoing culture. Agencies that prioritize client interests, pay attention to details, and document diligently will naturally have a “diverse and robust defensive shield” against E&O claims.
Notable Case Examples and Unique InsightsThe FYIExpress E&O Prevention page also highlighted several real-world case studies and special tips, which provide valuable insights beyond the general principles above. These cases show how small mistakes can snowball into lawsuits, and they reinforce why the preventive measures described are so important. Table 1 below summarizes some notable E&O scenarios mentioned on the page, along with the outcome and lesson from each:
E&O Risk Scenario (Agent Error)Outcome of the CasePrevention LessonCertificate Omission Misleads Client – Agent issued a certificate of insurance but failed to note a key policy exclusion (work in New York City). The client assumed they were covered for that project.When an injury occurred on the NYC job site, the insurer denied the claim due to the exclusion. The contractor sued the agency for misrepresentation and negligence. The court allowed the lawsuit to proceed against the agency, finding that the certificate “misrepresented” coverage and the client reasonably relied on it to their detriment. The potential damages were substantial (hundreds of thousands of dollars in defense and settlement costs).Always accurately represent coverage on certificates. Have a standard certificate-issuance process and include any relevant exclusions or endorsements with the certificate. In this case, attaching the exclusion documentation to the certificate could have prevented the client’s mistaken belief and the ensuing lawsuit. Make it a rule: never issue a certificate that implies broader coverage than the policy actually provides.| Umbrella Policy Missing UM/UIM Coverage – Client requested an umbrella policy with an additional $1 million in Uninsured/Underinsured Motorist (UM/UIM) coverage, and the agent said it would be provided. The agent, however, failed to add the required UM/UIM endorsement to the umbrella. | After a devastating car accident with an underinsured driver, the client discovered the umbrella had no UIM coverage beyond the $100k in the auto policy. He sued the agent for negligent procurement. A jury found the agent 90% at fault and awarded roughly $753,000 in damages (after offsets) to the injured client. The case was upheld on appeal – the agent’s failure to secure the requested coverage made him liable for the shortfall. | Deliver on coverage requests. If a client specifically asks for a coverage or limit, make absolutely sure it is included, or document clearly if it cannot be. In practice, this means double-check endorsements on umbrella and excess policies. Never assume an umbrella automatically provides certain coverages – confirm it in writing with the insurer. In this case, the agent should have secured the $1 million UIM endorsement or obtained a signed waiver if the client declined it. The lesson: never neglect to add a coverage the client was led to believe they had. One small oversight in paperwork can cost hundreds of thousands in liability. |
| Agent Failed to Forward Claim – A client was sued (vehicle accident) and immediately notified their insurance agent, but the agent did not inform the insurer. No defense was provided by the carrier since it never knew of the suit. | The insurer only learned of the lawsuit after a $1.2 million default judgment was entered against the insured (due to the lack of defense). By then it was too late – the insurer denied coverage for late notice. The injured plaintiff then sued the agency for negligence. The courts held that the lawsuit against the agent was timely because the “injury” (the uninsured judgment) occurred much later than the agent’s initial error. The agency and insurer ultimately faced protracted litigation and were unable to dismiss the case on technicalities. | Report claims immediately and systematically. This case underscores that dropping the ball at claim time is a sure path to an E&O nightmare. Agencies should have fail-safe procedures: for example, assign two staff members to every claim notice – a primary and a backup – to ensure it gets reported to the carrier without delay. Keep a log of claim notices and confirmations from insurers. Had the agent simply forwarded the lawsuit to the insurer when notified, the insurer would have defended the case and no default judgment would have occurred. In short, treat every claim notice with urgency. Prompt reporting can avoid a situation where an insurance coverage defense (like late notice) leaves the client looking to sue their agent. |
| Providing False Policy Information (Potential Fraud) – A contractor’s liability policy had actually renewed, but the agency mistakenly (and repeatedly) told a claimant that the policy had lapsed. The agency even issued a certificate showing an expired date. The homeowners relying on this info delayed pursuing a claim with the insurer. | Believing there was no insurance, the homeowners went after the contractor directly and won a judgment – which went unpaid. When they discovered the policy had in fact been in force at the time of their loss, they filed suit against the agency and its president. The court dismissed negligence claims due to lack of contract, but allowed a fraud claim to proceed against the agency. In other words, even without a direct client relationship, an agent can be liable for fraudulent misrepresentation to third parties. The case was sent back for trial on the fraud allegations. Multiple agency staff giving the same wrong answer suggested the agency’s internal records were wrong, a serious oversight. | Always provide accurate information – to clients and anyone else entitled to facts about a policy. An insurance agency must keep its records up-to-date so it knows the true status of coverage. In this scenario, the agency should have verified the policy status before speaking and corrected the certificate. Misinforming a claimant or certificate holder can escalate to an allegation of fraud, which is far worse than ordinary negligence (and often not covered by E&O insurance!). The clear lesson is to never guess or give out unverified policy information. If someone has a legitimate interest in a policy (like a certificate holder or claimant), ensure they get the correct info or direct them to the insurer. Honesty and accuracy preserve trust and prevent liability. |
| “Full Coverage” Misunderstanding – A client told her agent she wanted “full coverage” on her newly built home. The agent did not clarify what that meant and did not recalculate the replacement cost for several years. In the meantime, the home’s insured value became outdated. | After a disastrous house fire, the clients discovered their homeowners policy was $88,000 short of the amount needed to rebuild their home. They sued the agent, alleging she failed to advise them on proper coverage limits. The court ultimately sided with the agent – ruling that without a special advisory relationship, the agent had no legal duty to ensure adequate insurance just from a request for “full coverage”. The case was dismissed, leaving the homeowners to absorb the $88k loss. However, the agency’s reputation undoubtedly suffered, and this situation likely strained the client relationship permanently. | Define coverage needs explicitly – don’t rely on ambiguous requests. If a client asks for “full coverage,” that is not a precise term. Agents should politely probe what the client means and educate them. In this case, the agent should have conducted a fresh replacement cost evaluation and explained the coverage options. Even though the agent won the lawsuit by law, the clients still ended up bitter and out-of-pocket. The insight here is that winning an E&O lawsuit is a pyrrhic victory if the client is left unhappy and underinsured. It’s far better to avoid the conflict altogether by ensuring the client truly has the coverage they need. Agents should be proactive: if a client is unsure about limits or says “you handle it,” take that as a mandate to advise fully. Had the agent ensured adequate limits, the entire problem would have been avoided. As one expert noted, even when an agent isn’t legally at fault, “it would have been much better for all involved if adequate coverage had been purchased.” In practice, always strive to meet the client’s needs in fact, not just fulfill the literal minimal request. This protects the client and the agent’s reputation alike. |
Table 1: Real-world E&O scenarios illustrating causes and prevention strategies. Each case underscores how a particular error can lead to litigation, and how following best practices can avert such outcomes.
Beyond these cases, the webpage and related resources provided additional insights and tips for E&O loss control. Some notable ones include:
  • Confirm All Key Details (Don’t Assume): A simple but critical tip from the page is “Never assume the named insured owns the building”. In other words, verify the facts. If your client’s policy has a property or entity listed, confirm who the actual owners or parties are. For example, a business owner might personally own the building used by the business. If an agent wrongly assumes the business entity owns it and doesn’t insure the individual owner, that owner is left uninsured – a huge gap in coverage waiting to spark an E&O claim. Always ask seemingly “obvious” questions about ownership, additional insureds, lienholders, etc. to ensure the policy covers the correct interests.
  • Embrace Multilingual Communication: The FYIExpress page acknowledges the importance of serving clients who speak other languages, linking to Spanish-language insurance information. A unique insight here is that language barriers can lead to misunderstandings and E&O exposures. If a client isn’t fully fluent in English, provide policy explanations or resources in their native language whenever possible. Ensuring the client truly understands their coverage is part of an agent’s duty of care. Offering translations or bilingual support can prevent costly miscommunication. In short, make sure every client comprehends their coverage – no matter what language that requires.
  • Recognize Carrier vs. Agent Liability: Most E&O claims are filed by insureds, but the page notes that insurance carriers themselves have sued agents in certain situations. This can happen if an agent’s error causes the insurer a loss – for instance, an agent failing to disclose material risk information, or misappropriating premiums, might prompt the insurer to take legal action. The takeaway is that agents must uphold professional standards not only to avoid client claims but also to maintain good standing with carriers. Be truthful and thorough in underwriting submissions (never withhold critical info from an underwriter), follow carrier guidelines, and keep accurate accounting. This helps avoid conflicts with the insurers you represent and keeps your E&O exposure in check on all fronts.
  • Continually Improve Agency Staff and Processes: A recurring theme is that “Agencies don’t make mistakes, people do.” Every team member needs to know what is expected of them to prevent E&O incidents. Regular training and clear procedures are essential. Establish an internal culture where everyone double-checks their work and feels responsible for error prevention. For example, conduct internal E&O prevention meetings or quizzes (the page even offers a 5-question E&O quiz for agents to test their knowledge). Emphasize documentation habits across the team. When agency staff understand the E&O implications of their daily tasks, they are more likely to be vigilant. Quick tips like “never sign an application on behalf of a client” and “don’t make promises you can’t keep” should be ingrained in every employee. By fostering a strong E&O awareness culture, an agency can significantly reduce the likelihood of costly mistakes.
ConclusionThe FYIExpress “E&O Prevention” page provides a comprehensive look at how insurance agencies can guard against errors and omissions claims. The strategies range from technical steps (like attaching policy exclusions to certificates or using coverage checklists) to big-picture practices (like educating clients, documenting decisions, and nurturing trust). E&O prevention is ultimately about diligence, communication, and client service. An agency that acts in the client’s best interest, stays organized, and communicates clearly will inherently have fewer E&O issues. There is no single magic bullet – rather, success comes from layering multiple best practices as a “defensive shield”. The more robust and diverse your prevention measures are, the less likely a client (or any party) can mount a successful claim against you. In summary, by learning from common failures and real case lessons, and by implementing the preventive measures discussed – from careful policy handling to honest client interactions – insurance professionals can significantly reduce their E&O risk while also providing better service to their customers. This proactive approach not only avoids lawsuits and out-of-pocket costs, but also builds a reputation for reliability and professionalism that is invaluable in the long run.
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  • Zalma on Insurance
    • It is Expensive to Lie to Your Insurer November 29, 2023
    • Unambiguous Policy Terms Must Be Applied November 28, 2023
    • The Perfect Gift for Your Insurance Company & Insurance Claims Clients November 27, 2023
    • Insurance Does Not Cover a Sure Thing November 27, 2023
    • You Win Some & You Lose Some November 24, 2023
    • No Sprinklers – No Coverage November 23, 2023
    • I AM THANKFUL November 22, 2023
    • “Personal Injury” Coverage Exclusion Eliminates Coverage November 22, 2023
    • No Good Deed Goes Unpunished November 21, 2023
    • Why Insurance Fraud Is Costing You & Your Neighbors November 20, 2023
    • You Only Get What You Pay For November 17, 2023
    • Lawyer Seeks Voluntary Disbarment For Fraud November 16, 2023
    • Zalma’s Insurance Fraud Letter – November 15, 2023 November 15, 2023
    • No Written Agreement Ends Claim as an Additional Insured November 14, 2023
    • Conditions in First Party Property Insurance # 2 November 13, 2023
    • INSURANCE FRAUDSTER WAS A VERY BAD MAN November 13, 2023
    • How to Give a Gift to Insurer Employees November 10, 2023
    • Contiguous Trigger is Law in West Virginia November 10, 2023
    • Insurance Fraud is a Violent Crime November 9, 2023
Insurance Fraud Prevention
Burglar turns broken back into fortune
http://www.insurancefraud.org/article.htm?RecID=3045

Crooks fingered for sawing Porky’s hand
http://www.insurancefraud.org/article.htm?RecID=3238
​

Staged-crash ring crashes and burns
http://www.insurancefraud.org/article.htm?RecID=3386#.VK10x4rF_Cc

Crooked lawyer feasts on client settlements
http://www.insurancefraud.org/article.htm?RecID=3456

Lawless Lamborghini ride means turnpike to prison
http://www.insurancefraud.org/article.htm?RecID=3310
​Roof caves in on DJ’s stormy insurance con
http://www.insurancefraud.org/article.htm?RecID=3116


Home insurance arson shrouds child murder plot
http://www.insurancefraud.org/article.htm?RecID=3389#.VK13torF_Cc

Can you spot a liar? Here are some things to look for
Sometimes what we don’t say speaks far louder than our words.…Read More


Devlish Christian insurer milks motorists
http://www.insurancefraud.org/article.htm?RecID=3042


Muddled excuses for fake car theft backfire on cop
http://www.insurancefraud.org/article.htm?RecID=2928


Hired torch blows himself up in botched home arson
http://www.insurancefraud.org/article.htm?RecID=2892

How to avoid becoming a victim of 'flood vehicle' fraud
Flood-damaged vehicles offer a tempting opportunity for criminals to defraud unsuspecting consumers.…Read more


Devout grandmother burned alive in home arson
http://www.insurancefraud.org/article.htm?RecID=3122


Jittery agent shoots investigator just doing her job
http://www.insurancefraud.org/article.htm?RecID=2935


Crooked lawyer feasts on client settlements
http://www.insurancefraud.org/article.htm?RecID=3456


Playing with fire burns homeowners and hired torch
http://www.insurancefraud.org/article.htm?RecID=3118

5 Examples of Insurance Fraud

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​An Insured Cannot Commit a “Little” Fraud Anymore than be a “Little Dead”
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AUTO INSURANCE FRAUD MAXIMS
To a person intent on perpetrating an insurance fraud two maxims become immediately clear:
  1. Insurers don’t care.
  2. most adjusters and investigators wouldn’t know a fraud if it presented itself to them wearing a sign saying: “I am a fraud.”
Very successful, multimillion-dollar businesses were set up with those maxims in mind.
The most successful is the automobile personal injury fraud. It exists in almost every metropolitan community. Each perpetrator of an automobile personal injury fraud varies the methodology slightly.
Rather than isolated instances of fraud they are run like a large corporate entity. The following are the categories of individuals involved in the automobile personal injury fraud ring:
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THE RECRUITER
This is a person who worked in the community to recruit two different types of people: the victims and the insureds. They recruit victims from the ranks of the unemployed, individuals on welfare or anyone in need of quick cash. The same sources provide insureds who may even include wealthy, or well-off people, who need cash to support their purchase of illicit drugs.
The recruiting techniques are simple and straightforward. A victim is offered $300 to $500 cash to allow his name to be used in a report of an automobile accident. Sometimes they must actually sit in a car that is then struck by one of the recruited insureds. Sometimes they only sell the use of their names.
In fact, depending on the insurer involved and the reputation it has for investigation of such claims, living persons are not necessary to play the role of victim. In such situations, the insured merely runs his vehicle into a stationary object such as a garage wall or telephone phone to create damage to his vehicle. He reports that he struck the victim’s vehicle in a private parking lot and that the victim and four of his passengers are reporting personal injuries. All of the victims hire counsel. Almost always the victims hire the same lawyer who refers them all to the same physician or chiropractor.

THE DISHONEST LAWYER
Depending on his experience, the lawyer either recruits the recruiter or is recruited by the recruiter. The recruiters usually watch the results of the bar examination and then make contact with a newly admitted lawyer. They advise the lawyer that, for a small share of the proceeds, they can provide him with ten to twenty new personal injury plaintiff cases every month. They claim that they have this source of business because they work as an administrator for a local chiropractic clinic or in a body shop.
The young, gullible lawyer, either not realizing that it is a crime to pay a person for a case, or is so hungry for work that he or she ignores the law, agrees. The young lawyer never meets his or her client. He or she gets contingency fee agreements from the recruiter and medical reports reflecting the injuries. He then makes demand on the insurer who has already received a report from its insured (who was paid to do so) advising that the accident was the insured’s fault.
The lawyer makes demands on the insurer for settlement. After a few telephone calls and copies of the medical reports he settles with the insurer for between $5,000 and $10,000 a plaintiff. The lawyer keeps all of the money less the fees of the recruiter, the victim and the insured.
The lawyer makes an excellent living earning more money than he ever would on salary for any law firm. He learns the trade and recruits his own recruiters to keep more of the money.

Greed and the Dishonest Lawyer
The people involved in staged automobile accident claims are usually successful until they get greedy. In 2011, Robert Belshaw, 56, a Marina del Rey, California attorney was sentenced to seven years and eight months in prison for his role in an auto insurance fraud ring that stole about $3 million. Belshaw was found guilty in March of five counts of money laundering and three counts of state income tax evasion.
A co-defendant and ring leader, Solomon Morris Davis, 61, of Rancho Palos Verdes, also was convicted on 20 counts of insurance fraud and conspiracy. He was sentenced in April to 12 years in state prison. The ring staged accidents to defraud insurance companies.
Prosecutors told the press that Davis set up Total Medical Healthcare in the mid-Wilshire area of Los Angeles under the name of his wife, Dr. Jody Hunter-Davis, as part of the scam. She, however, did not practice medicine at the clinic and was not a suspect in the case. As part of the fraud scheme, the signatures of doctors who worked part-time at the clinic were forged for inflated billings.
Davis recruited Belshaw to run a sham law practice that negotiated the fraudulent billings with insurance companies from September 1999 to April 2003. Belshaw failed to claim any of his earning on state income tax returns from 1999 to 2001, officials with the state Franchise Tax Board said. Belshaw owes the tax board more than $31,600 in unpaid taxes, penalties, interest and the cost of the investigation.
Had Mr. Belshaw limited the number and extent of fraudulent claims he would probably still be presenting fraudulent claim and earning a good living. Because he got greedy, because he failed to report the money he earned from his criminal activity, he is now residing in the grey bar hotel operated by the state of California and can only wear an orange jump suit.
This post was adapted from my book, Insurance Fraud Costs Everyone Available as a Kindle Book and Available as a Paperback from Amazon.com.

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Eddie K. Emmett, 200 Russell Court, ​Canton, GA 30115