In a Post I started yesterday, the topic of Insurance Fraud came up.
The point being raised was whether damage to a vehicle's rear fender from a previous accident, and not repaired, be reported to the Insurance Company if further damage had occurred to the same area. If not reported, would that be considered Insurance Fraud.
In the scenario I wrote, I would not consider it as being Insurance Fraud.
A basic definition of Insurance Fraud is the wrongful deception of an insurance company for the purpose of wrongfully receiving compensation or benefits.
If your claim is merely for the damages that were legitimately incurred, you are entitled to receive said compensation.
Here are a few additional scenarios being presented for relevance:
1. Your 1,300 square foot house, built in 1994 needs a new roof, as it has started to lose shingles, and some water damage is being spotted on the inside.
Before you can have it repaired, which is not covered by your insurance policy, a Category 5 Hurricane comes through your county and rips the roof off of your house.
A. Count your loss and move to another city and buy another house;
B. File a claim with your Insurance Carrier to have your roof replaced, not telling them about the need to have the tiles replaced based on age;
C. File a claim with your Insurance Carrier, making sure to point out that it needed to be re-roofed, provide them with the estimate you received, so that they can deduct said amount from the total of the claim;
D. Hire an attorney to handle your claim and let him decide if he wants to tell them about the re-roofing issue.
2. You've been driving your new 2018 Mercedes Benz C-Class; however, it has gotten dinged by grocery carts, door panels scratched from parking too close to the next vehicle in the parking lot, had the back bumper dented from backing into a telephone pole, and a broken tail light from your son hitting it with a fly ball.
Then one day you are t-boned in an intersection while you had the green light and the Mercedes flipped twice and was totaled. You were not seriously injured. The Police report vindicates you and puts the blame fully on the vehicle running the red light.
A. Take the cash settlement and buy another vehicle;
B. File a claim with your Insurance Carrier to have your vehicle replaced, not telling them about all the prior damage that was never fixed;
C. File a claim with your Insurance Carrier, making sure to point out that it had all these prior issues with it, and ask that they take them into account when processing your claim amount;
D. Hire an attorney to handle your claim and let him decide if he wants to tell them about the prior damage.
Are your responses different in those two scenarios.
What would the average, law abiding citizen do in those cases.
Would answer B in either case truly be considered Insurance Fraud?
Your opinions are welcome.