A staged accident investigation in Roanoke, Va., led to an award for a Nationwide Insurance special investigator. Suzy Clingman-Taylor was named Investigator of the Year by the Virginia Chapter of the International Association of Special Investigation Units (VA IASIU) last month.
Clingman-Taylor, who held jobs as a police officer and as an investigator for the Department of Corrections prior to working at Nationwide, was assigned an investigation on a claim involving collision damage and multiple injuries.
The policyholder alleged that while a passenger in her own vehicle, the driver of her car lost control and struck two vehicles already stopped at a traffic light. The policyholder and the three other occupants of the insured vehicle all claimed injuries. The physical damage included the insured auto and two other cars.
“The insured and her father were both passengers in her vehicle. The driver of the car was a family friend. They wanted to total the vehicle and make bodily injury claims, so the driver of the vehicle deliberately drove into two vehicles stopped at a stop sign. Luckily neither of the women in the other vehicles were injured,” she said.
The two year investigation revealed a number of prior losses involving the policyholder and her father, as well as their vehicles. Clingman-Taylor was the sole investigator on the case and her work led to the Virginia State Police (VSP) obtaining confessions from both the driver and the passenger in the vehicle, who also admitted to the staged accident during Examinations Under Oath.
“This was a particularly concerning situation,” said Jerry Altieri, her supervisor at Nationwide, “because the perpetrators of this insurance fraud attempt were willing to intentionally drive their vehicle into the non-moving vehicles of completely innocent people.”
The case was prosecuted by the Roanoke County Commonwealth Attorney’s Office and the driver and one of the passengers in the vehicle pleaded guilty to a misdemeanor charge of Obtaining Money by False Pretenses. The policyholder’s father pleaded guilty to a felony charge of Obtaining Money by False Pretense in Roanoke County and was given a five-year prison sentence and five years probation. He was also ordered to pay $4,352.19 in restitution for payments made to repair the damages to the three vehicles involved in the loss. The policyholder was also found guilty of Felony Obtaining Money by False Pretense – her sentence is pending.
More than $83,000 in fraudulent claim payments were denied as a result of Clingman-Taylor’s initial investigation and early discussions with the VSP.
The case turned out to be the biggest in Clingman-Taylor’s career and led to additional convictions in a neighboring county.
As a result of information developed regarding the activities and method of operation of the policyholder’s father in Nationwide’s loss, the state police were also able to develop additional charges against him. Additional information developed during her investigation and testimony regarding an online fraud scheme and tax evasion in a neighboring jurisdiction was vital in the conviction of the policyholder’s father for additional felony counts of Obtaining Money by False Pretense as well as Failure to File Tax Returns.
Her best tip to fellow SIU investigators and adjusters handling a potentially fraudulent claim is to follow their instincts.
“If something doesn’t sound right, it probably isn’t right. Just go ahead and keep asking questions,” Clingman-Taylor said.
Equally important are relationships with local law enforcement agencies.
“We made an early referral to them [Virginia State Police partners] on this case and that really made a difference,” she said.
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