Preventing Insurance Fraud - What is an Insurance Adjuster?

Most of us know what an insurance company is. But just what is an insurance adjuster?

Sometimes it’s not clear who adjusters are and how they’re trained for the job. (After all, how many colleges offer “insurance adjusting” as a major?)

To get some answers, we went behind the scenes with Chad Smith, a property specialist at Erie Insurance who handles large losses. Read on to learn more about him and all the important ways he helps Customers in their time of need. (And feel free to check out our short video above to learn even more!)

In your own words, what is an insurance adjuster?

To me, an insurance adjuster is someone who has a great deal of responsibility and accountability. An adjuster owes that not just to the company he or she represents, but to the customers who’ve experienced a loss.

At Erie Insurance, adjusters are the ambassadors of the company. People don’t really see how an insurance company works until they have a loss, and we represent that.

What kind of background do you need to become an adjuster?

More often than not, you need to have a college degree. I have a business degree, but insurance adjusters can pursue other fields as well. I would also recommend adding computer and math classes to your coursework.

How did you become an adjuster?

ERIE hired me as an adjuster shortly after graduating from college. I went through a few months of training that included both classroom and field training. I was tested on information and then spent some time out in the field with seasoned adjusters and appraisers to learn about what they did first hand. Because I work directly for an insurance company, I don’t need a license to be an adjuster. However, the rules vary by state.

What kind of skills do you need as an adjuster?

Being people-oriented is a must. You need to be able to empathize with the Customer by putting yourself in their shoes. Honesty and integrity are essential in establishing trust.

Because of the way the field is evolving, you need to be really comfortable with technology or be willing to learn it. To grow as a professional adjuster, you have to move beyond in-house training and pursue professional insurance designations like the Chartered Property Casualty Underwriter (CPCU) and Associate in Claims (AIC).

What’s a normal day like?

There really is no normal day. And that’s one reason why I love my job!

In order to handle it, you have to structure your days to a certain degree, but also maintain flexibility. I might plan to make calls all morning—but if I get an urgent claim, I need to reorder my day. I’m always busy.

What hours do you work?

I usually start early and end late. Sometimes I work weekends. I enjoy a lot of freedom with this position—and I’m available almost 24/7 because that’s how you provide great service. You can’t be stuck in the traditional nine-to-five, Monday through Friday mindset as an adjuster.

What’s the most memorable claim experience you’ve had?

Over the years, I’ve had many. One that stands out is working during the 2011 tornado catastrophes in North Carolina, Virginia and Tennessee. ERIE was the first insurance company on the scene. There was a lot of damage, but I was able to respond quickly and help Customers affected by the tornadoes. The fast response was made possible by the way ERIE set up its catastrophe team units. Some people I spoke to said neighbors with other carriers hadn’t even heard from their adjusters yet. It was extremely gratifying to help ERIE’s Customers when they really needed it.

What’s the most gratifying part of your job?

Knowing in my heart that I did the best I could for ERIE and for the Customer on every claim that I handle. I remember one claim we had to deny; even still, the Customer sent me a card thanking me for how polite and helpful I’d been during the process. Everyone should receive the same level of service, regardless of the outcome.

Do you have the backing of a company that offers the kind of top-notch service Chad delivers? If not, contact a local Erie Insurance Agent in your community to discuss your options and get a free quote.

Kaori Fuchi Tax and Consulting Tokyo Japan



Kaori Fuchi Tax and Consulting is renowned for providing professional and client-friendly services such as tax consulting and tax compliance services to mainly foreign companies and individuals.

For many foreign companies, the Japanese tax system and regulations can be complex and difficult to understand. Our company offers full tax and accounting services so that foreign businesses can concentrate on their operations. We also offer responsive and efficient services such as bookkeeping and payroll.

Partner: Kaori Fuchi (Certified Tax Accountant)

• Born in Osaka
• Graduated from Kansai University of Foreign Languages
• Completed Master Degree in Law at Doshisha University

Profile

Worked for Northwest Airlines for several years before becoming a tax accountant.

Before Working for Ernst & Young, worked for a privately held accounting office. At Ernst & Young, experienced working at the Ministry of Economy, Trade and Industry. Specialized in international tax reform.

December 2010, Established Kaori Fuchi Tax & Consulting.

November 2012, Established Orange Bridge Co., Ltd. in Hong Kong. (Providing tax and accounting services in Hong Kong)

April 2013, Established Orange Accounting Co., Ltd in Tokyo. (Providing bookkeeping and payroll services for foreign companies in Tokyo, Japan)

Message From Kaori Fuchi

My main strength is treating customers with sincerity and with courtesy. "It's been really great to have met such courteous a tax advisor who can explain everything in English." Comments like these make me feel happy and motivate me to serve our clients even better.

Unlike experts from large firms, I am happy to be known as the ‘familiar’ tax advisor who is dedicated to supporting your business. This I see as the mission of my life.

Preventing Insurance Fraud - How to Get 4 Overlooked Business Risks Covered



The success of any business depends on hard work and ingenuity. Business insurance helps protect the effort and money you’ve invested in your business is covered in case a disaster strikes. But because businesses are so diverse, there are a variety of optional coverage that you should consider, too. These extras are added to your business insurance policy as endorsements.

Here’s how to help cover four common business risks with endorsements.

1. Data breaches: Any business that has personal or medical information about customers, tenants or employees is at risk for a data breach.

Don’t think it can’t happen to you? A study commissioned by Hartford Steam Boiler and conducted by the Ponemon Institute found that over half of small businesses have experienced a data breach, and many did not inform victims as required by state law. Most states have breach notification laws that not only require a business owner to inform any affected individuals (customers) of a data breach but also specify the manner and period in which the business owner must inform customers.

Two coverages you may want to consider:

• Data Breach Response Expenses: It could cover your expenses to notify affected individuals of a breach per state laws.
• Data Breach Liability Coverage: It could cover damages that you are legally obligated to pay due to fraudulent use of your customers’ non-public personal information that is lost, stolen or accidentally released. It also covers the cost to defend lawsuits seeking damages.

2. Employment liability: These days, hiring, firing and day-to-day employee management can be a risky business. You’d like to think that your employees would never dream of filing a claim or suit against you or your business for discrimination, wrongful termination, harassment or sexual harassment. Unfortunately, it does happen. Responding to claims or suits like these will require time and money.

The Equal Employment Opportunity Commission (EEOC) received 89,385 charges of workplace discrimination during fiscal year 2015, which ended in September. EEOC also secured more than $356.6 million for victims of discrimination in the private sector.

With Employment Practices Liability Coverage, you will not have to face an employment claim on your own. It can help protect you against liability damages and cover defense costs.

3. Professional liability: You’re expected to have technical knowledge or training in a particular area of expertise or perform certain services according to the standards of your profession. If you fail, you could be held responsible for any harm that you caused to another person or business. Professional liability coverage can provide you with protection for claims arising out of negligent business or professional practices.

4. Personal identity theft: As a small business owner, your personal credit may be tied closely to your business. Having your own identity stolen, could jeopardize your credit and affect your business operations.

Last year, fraudsters stole $16 billion from 12.7 million U.S. consumers, according to the 2015 Identity Fraud Study, released by Javelin Strategy & Research. That means that every 2 seconds in 2014 there was a new identity fraud victim.

Personal Identity Recovery coverage can be added to a business insurance policy1 and provide:

• Case management services to assist you in recovering a personal identity by contacting authorities, credit bureaus and businesses to correct the records.
• Reimbursement for necessary and reasonable expenses that you incur because of identity theft, including lost wages, mental health counseling and child and elder care supervision costs.

Talk to an Erie Insurance agent to learn more about the risks that you may face and how to protect your business.

Kaori Fuchi Advisors Tokyo Japan - Fees

Modest Fee

Our fees vary accordingly to the complexity of the business, degree of difficulty and amount of work required. Please see below for a general indication of our fees. Please feel free to contact us for an estimate.

Schedule of fees

For Both Companies and Individuals

Tax Consulting - 30,000yen / 60min.
Preparation for Corporate Tax returns - Support annual financial statements and tax returns according to Japanese regulations. From 250,000yen
Tax and Accounting Services - Monthly book review and Tax advice on-call service From 30,000 yen per month
Second Opinion Services - From 30,000 yen per month
Bookkeeping Services - From 20,000yen per month
Payroll Services - From 20,000yen per month
Tax Due Diligence & Tax Accrual Review - From 200,000 yen. Please contact us for an estimate.
Tax Return Review - We can provide a quote according to the contents.

EX: When you have salary income (20 million)
Dividend income (150,000yen), Interest income (500,100yen)

Basic fee - 120,000 Yen
Dividend income - 30,000 Yen
Interest income - 50,000 Yen
Total - 200,000 Yen

Social Media Helps Solve Insurance Fraud Cases



It’s Monday morning and Jeremy McFadden, a fraud program specialist at Erie Insurance, is surfing Facebook.

Jeremy isn’t reliving memories from the weekend—he’s knee deep in investigative work that saves ERIE and its Customers many thousands of dollars every year.

“Though the vast majority of claims are legitimately submitted by honest people, there is a small portion that requires further review,” says Gene Robertson, director of Special Investigation and Analysis at ERIE. “Social media is absolutely helping us do that.”

Insurance fraud cases

Insurance fraud is a serious crime in which someone knowingly and intentionally sets out to deceive their insurance company. It is different from an innocent misrepresentation in which someone unknowingly presents false information to their insurer. (For instance, a fire destroys an appliance and someone overestimates how much it cost because he lacks a receipt.)

Circumstances surrounding suspected fraud tend to be highly unusual. “There is a big red flag when truly fraudulent activity occurs,” says Gene. Insurance fraud is a crime in every state—and in most cases, it’s a felony.

Insurance fraud cases end up costing Customers

The property and casualty insurance industry estimates that fraud costs between $30 and $60 billion a year. Insurance fraud is the second most expensive white-collar crime after tax evasion—and it costs honest Customers, who eventually foot the bill in the form of higher premiums.

Today, more people are making this connection. “Thanks to successful advertising and public awareness campaigns over the years, the way the public views insurance fraud has really changed,” says Frank Scafidi, director of public affairs at the National Insurance Crime Bureau (NICB), a not-for-profit organization that partners with insurance companies like ERIE and law enforcement agencies to fight insurance fraud.

“People used to brag about getting one over on insurance companies, but there’s now a realization that this causes your friends and family to pay more,” he says.

Piecing it all together

ERIE fights insurance fraud cases on many fronts. There’s old-fashioned detective work like visiting premises, conducting interviews and acting on tips. ERIE also uses sophisticated software and collaborates with the NICB, law enforcement and other insurers.

Fraud investigation is about seeing the whole picture, and social media posts, photos and videos are increasingly a part of that picture. This doesn’t mean all information is free game. ERIE respects Customers’ privacy rights by only looking at publicly available information. That means ERIE investigators will never create fake profiles to “friend” or “follow” a Customer with a suspicious claim.

“Our whole premise at ERIE is about doing the right thing,” says Robertson. “Protecting and respecting our Customers’ privacy is a priority in all we do, including our investigative work.”

Fortunately, such measures usually aren’t needed.

“What we find is that fraudsters often neglect to cover their tracks,” continues Robertson. “Even if their profile is private, they often post to pages of friends and groups whose accounts are public.”

A few recent insurance fraud cases

Just a few instances in which information gleaned from social media played an important role in unraveling insurance fraud cases included:

• The Playground Scam: A claim was filed for a playground that was allegedly damaged beyond repair in a storm. The playground was disposed of, leaving ERIE no way of verifying the claim. A few weeks later, the claimant was selling the same playground on Facebook.
• The Tractor Pull Scam: A claim was filed alleging an engine was damaged when someone put the wrong fuel in it. ERIE later found a YouTube clip and Facebook photos of the claimant participating in a tractor pull in the same truck. ERIE personal auto policies exclude coverage while participating in organized racing, high performance driving, stunting and similar sporting events.
• The Livery Van Scam: Several people simultaneously filed claims to an ERIE personal auto policy. ERIE later discovered a Facebook page advertising the claimant’s van as a public transportation business. ERIE personal auto policies exclude transporting people or goods for hire.

ERIE investigators have also unearthed many online photos and comments implicating claimants of committing workers’ compensation fraud. “I’ve seen claimants who are ‘too hurt to work’ post updates about their marathon training schedules or photos of themselves backpacking through the mountains,” says McFadden.

When ERIE presents someone with solid evidence of fraud, most people will withdraw or stop pursuing a claim. ERIE then turns things over to law enforcement, who will decide how to handle the crime.

You can help ERIE fight fraud

Though social media is playing an increasingly important role in combating fraud, your input still matters.

If you suspect that someone is committing insurance fraud, let ERIE know by calling the toll-free Fraud Hotline at 800-368-6696 or emailing fraud.finders@erieinsurance.com. Together, we can reduce this costly crime.

Tyre&Auto Southbourne Group Review: Make sure to have regular car maintenance



Maintaining the good condition of a car needs regular maintenance and necessary repair. Ensuring the safety of everyone concerned should also be the main concern of every driver. People should always keep the safety standards of their own cars as well as maintaining their perfect running condition to have a peaceful drive.

What comes first before learning how to move a car forward or backward? The answer is how to brake properly. For Tyre&Auto Southbourne Group, this symbolizes the importance of safety. The company understands the significance of safety in driving a car, so they only provide quality service to their customers to make sure that they would be danger-free inside their own car.

Tyre&Auto Southbourne Group is a family-operated company that has an excellent record in trading car parts and accessories. They offer car servicing, tyres, brake checks, MOT’s, and free seasonal tune-ups and check-ups.

Moreover, the company provides online transactions, which can deliver fast tyre quotation to their customers, making fitting faster. Tyre&Auto can also provide local collect and delivery of a car wherein you can be sure of its car maintenance or repair.

An MOT test is also possible with Tyre&Auto, and included in this examination is checking the safety of your car and the amount of exhaust emission. And in order to guide you in your yearly MOT certificate requirement, the company provides you with regular reminders such as when is the due of your test. This way, Tyre&Auto could be certain that you will renew your road tax and car insurance in time.

Each of us has our own destinations every day, and the introduction of cars made it easier for us to reach them. Owning a car can provide you with few advantages, so it’s apparent that you should take care of it properly. Such advantages include ease, mobility, personal comfort, and emotional or psychological benefits.

With 10 years of trusted service, Tyre&Auto Southbourne Group continues to deliver honest automobile services to their customers, and they always make sure to deliver top-notch maintenance and repair.

Online Security - Hidden Money Revelations

Of many interesting articles this week the one that caught my attention the most was about how to hide 400 million dollars. Written almost as if it were a mystery story, it tracks how an estranged husband sought to salt money away in international banks such that his wife would have no access in a divorce. As described in the article, the husband and the wife are not the kind of people with whom I would want to spend my time. They made money in fraudulent schemes, many of them played out on the internet. But liking or not liking them was not the intriguing point. It was the revelation within the story that shell companies and trusts designed to hide money — much of it either generated illegally or being held to avoid legalities — hold a purported 21 TRILLION of the world’s financial wealth. 21 TRILLION USD.

That is a staggering amount of money hidden away for purposes of keeping one step ahead of tax bills, blinkered business partners, or an estranged spouse. This sum undoubtedly includes money acquired through criminal activity. That is also an enormous percentage of the world’s wealth to be sequestered away from the active markets. In Adam Smith’s view of the world, that money would otherwise be available to generate new wealth, to grow economies, to pull scores of people out of poverty, or to keep existing working and middle classes from sinking back into want. No wonder many developed countries in Europe, Asia and the United States have been relatively stagnant for some time now. No wonder it is so difficult to penetrate endemic, destructive poverty in Central and South America, Africa, many parts of Asia and even within the United States and Canada. Wealth exists, but it is not in circulation. This article implies that it is sitting still in some remote bank in the Cook Islands as the result of nefarious activities abetted by legal tricks.

The issues surrounding global internet governance parallel these implications. First, international governance to bring the principles of justice to bear on either global banking or the internet does not exist. Second, the dark interstices of this ungoverned territory create a haven for illegality and fraud. Third, about the only means of penetration into this world is through intermediaries, for example lawyers and financiers, on-shore banks that assist in holdings and transmission. Lawyers afraid of losing their license, credit card companies and legitimate banks that avoid legal action or bad publicity, accounting firms that make an honest living often act as check points from perpetrator to ungoverned cash. But to the tune of 21 trillion dollars and the intractable challenge of cyber insecurity on the internet, intermediaries may not be good enough to stem the tide of layers and layers of illegality.

Where neither moral compass nor legal constraint exist, human nature’s darker side lurks. That dark side lends itself to unchecked violence and dehumanization that often lies within the illegal processes of generating much of this hidden wealth. Knowing that you can safely hide ill-begotten money encourages brutal behaviors played out in drugs and addiction, sexual slavery, extortion, theft and fraud. Moreover, these activities are not separate from global economics. From perpetration to prosecution, those activities create enormous inefficiencies within rational society. They also impose aching burdens on people who live by the rules.

I have no pat answers to these problems, but I feel strongly that they are vital questions. And the relationship between and among crime, global banks and the internet is more than an interesting insight about parallel tracks. Insofar as the internet facilitates crime, disorder and debasement, we must include its properties in our assessment as how to assert justice. The medium, curiously, is also the message.
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Luiesen Andersen

Author:Luiesen Andersen
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