It's my baby
The manager of the claims department in the branch where I worked
enjoyed a good laugh, and like other seasoned claims handlers he had become somewhat jaded
after reading so many thousands of reports of how various incidents took place. So
when he called me into his office after lunch one day and said, "Check out this
claim," I knew it would be interesting.
It seems a woman had entered onto the premises of Neiman-Marcus, a
store we insured, tripped on a misaligned marble tile on the sales floor, and fallen.
The first people to attend to the hysterical woman discovered a pool
of blood beneath her. Moments later they discovered the reason the woman was
screaming in horror. Lying in the pool of blood under the woman was a fetus.
She had had a spontaneous abortion, a miscarriage, as a result of the trauma.
Needless to say, the security and management personnel were
extremely concerned, not only for the woman's well-being but also for the store's exposure
to a claim of legal liability. There they were, looking at a bloody woman screaming
and a bloody baby lying next to her dead on their sales floor.
Now switch to the hospital emergency room. The woman has
calmed down a bit but still seems irrational. Examinations are conducted.
Tests are performed. Blood and urine are drawn.
While she's waiting in the ER for test results, she's visited by a
nurse, and she says, "Where's my baby?" The nurse tells her it's in the
hospital morgue.
The woman then says, "I want it. I want it back
now! You can't keep my baby. I can do what I want with it! It's my baby,
and if I want I can take it home and put it in a jar in my refrigerator."
Following which she was admitted to the psychiatric unit for
observation.
It turns out she had been pulling the old
"dead-fetus-in-pig's-blood" trip-and fall-trick. She'd scout out a place
where it looked like if she fell it was the store's fault, then she'd hide this human
fetus she had (which I guess she did keep in a jar in her refrigerator) and a
balloon of pig's blood up her skirt and go fall down. Amazing.
And she had actually tried this before, also, incredibly, at another Neiman-Marcus in Texas.
Tip to Professional Claimant Wannabes: If you're going to try this
particular scam more than once, move it around a little bit.
If you're thinking of taking up insurance fraud as a career,
you need to know about the Index Bureau.
Whenever any insurance company opens a liability or workers'
comp. claims file, the claims department sends a special form to the Index Bureau about
the claimant. Included on each such form are the claimant's full name and aliases,
D/O/B, SSN, date, time and place of accident, nature of accident, insured's name, injuries
sustained, lawyer's name, doctors' names, hospitals' and clinics' names, and any related
lawsuit numbers, not to mention the names of the insurance companies that handled any
previous claims made by that claimant along with their various file numbers.
When the Index Bureau receives a new form from an insurance
company, they respond by sending all the previous forms they've received about that
claimant.
When you see that a particular person has made an unusually
large number of personal injury claims, especially if the lawyers and "doctors"
he's used are known scumbags, you assume that this is one more attempt at fraud.
There's tons of people in the U.S. who commit insurance fraud by
faking accidents or merely by exaggerating their injuries and malingering.
Some claimants are mentally ill such as the woman above and Margo
Staples. A lot more are mere opportunists who take advantage of a situation if it
happens to arise. A few of them are regular part-timers, using insurance fraud as a
form of supplemental income. And some of them have no other career whatsoever and
are pretty good at it. All of them are crooks who are stealing your money at a
prodigious rate.
In some cases the attempt at fraud is pathetically obvious, as in
the case of Margo Staples. In others, if you as
the insurance adjuster can't prove the fraud in court you go ahead and pay just to close
the file. You don't pay much most of the time, but you do pay. And in a few
cases you get taken completely for a lot of money.
Up next is another bloody true story.
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