The case of the tenacious terrorist

Claims consultant Chris Tidball has worked for P&C carriers for more than 20 years, in roles ranging from claims adjusting to management. He has enough crazy claims stories to fill a  book--which, in fact, he's literally working on right now.

"Ibrahim Mohammed was a downright scary claimant," Chris recalls. Mohammed hailed from an area that was notorious for insurance fraud, where rumor had it that a lot of the fraud money was used to fund domestic and international terror cells.

Mohammed reported a stolen exotic car with expensive custom rims, that he had coincidentally purchased a rider for just a few days before the theft. The car was ultimately found, totally stripped. During investigation, the insurer tracked down the rims in the garage of a known associate of Mohammed's. 

"When we denied the claim, he threatened to bomb our claims office," Chris recalls. "We hired a security detail that stayed onsite 24/7 for about two months. I’ve had some scary situations, and this ranks right up at the top."

The case of the persistent physician 

"Dr. Katz" presented a claim for flood damage to his $200,000 Ferrari, claiming a tidal surge had reached the rocker panels and the car was totaled, Chris recalls. The insurer argued repair only and questioned the legitimacy of the claim, as there was no evidence of saltwater corrosion. 

Dr. Katz took the claim all the way to the CEO of the company "and proved that the squeaky wheel always gets greased first; we totaled the car, but also got a six-figure salvage bid," Chris says.

The case of the menacing monkey

In another Tidball tale, Chris recalls a shady body shop in Brooklyn that the insurer suspected of being behind some air bag thefts. 

"When I confronted the shop manager, he sicced his monkey on me," he says. "He had an actual pet monkey that was really mean and very aggressive."

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Like emergency room doctors, cops and priests in the confessional booth, insurance people are being asked to clean up the messes that people make--and worse, they’re expected to pay for them.

It’s little wonder that veteran insurance people can get a bit jaded. When it comes to claims--and human nature--they have seen everything.

We spoke with several long-time insurance professionals about the weirdest claims they’ve come across in their careers. Here are some of the strangest.

(Got a crazy claim story? Contact us!)

1. The case of the vanishing gold bars

Claims consultant Chris Tidball has worked for P&C carriers for more than 20 years, in roles ranging from claims adjusting to management. The client whom he recalls as the “biggest nut” was Walter A., who presented a claim for a stolen van that was carrying $500,000 in gold bars, which, of course, he wanted covered as well. “Imagine our shock when the van turned up burned to a crisp and all the gold was missing.” Walter would personally come to the office every morning at 8 a.m. to demand his check—a ritual that continued for around 90 days. “He would come in and get belligerent, then would feign having a heart attack, asking us to help him find his nitro pills. He was truly certifiable.”

2. The case of the gypsy curse

Another Tidball tale involves a gypsy who roamed around Southern California. This gypsy had a van that he reported stolen that, like Walter’s, contained lots of valuable “stuff,” which the gypsy could somehow never describe beyond saying it was important. When Tidball told him he had to deny the claim (which was “complete and utter B.S.”) the case went to trial. During an examination under oath, the gypsy pointed a magician’s wand at Tidball and started speaking a strange language in an attempt to cast a curse on the insurance man.

3. The case of the cruising cat ladies

Steve Schroeder, vice president of NFP, has been in the property-casualty business for almost 25 years, on both the broker and carrier side. One of his most memorable claims cases involved a trucking-company client that had a claim filed against a driver. The claimant alleged the truck hit a station wagon and injured the driver and her passenger. The truck driver insisted that it wasn’t his fault; the vehicle had appeared out of nowhere. Investigating state police and SIU personnel found no truck skid marks, but several dead cats on the highway at the accident site. It turned out the women, whose station wagon had been loaded with cats, had been literally driving in circles in the rural area – first in the southbound lane, then crossing the embankment and heading north. When the truck driver T-boned the station wagon, several cats flew out the vehicle’s windows and were killed. The claim was pulled.

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I'll give you 2 hints: Lyft and Uber

Every year one story involving insurance seems to capture the public’s attention and this year that story was ridesharing.

The popularity of commercial ridesharing, which connects drivers and riders for a fare with the click of a button on a smartphone app, has skyrocketed across the country in recent years. However, transportation network companies like Uber and Lyft have not only “disrupted” the taxi’s traditional drive-for-hire business model, but have also presented challenges for policymakers and insurers who have a vested interest in protecting the public.

The story that emerged this year had its roots in regulations passed by the California Public Utility Commission in the fall of 2013 and really emerged into public view New Years’ Eve when a driver for Uber struck and killed a 6-year-old in San Francisco. Since then, as the transportation network companies expanded their operations across the country, controversy, cease-and-desist orders, fines for operating without a license, and legislative and regulatory battles have followed.

The narratives involved were quite simple: “upstart tech firms fight cumbersome regulations that stifle innovation and jobs,” “taxis seek level playing field regarding regulations,” “marketplace innovation is great, but the vehicles used in ridesharing services must be properly insured to protect the public.” The TNCs marshalled celebrity investors, a loyal customer base and everyday people who drive for the services to convince policymakers their operations were different from taxis. Meanwhile, the taxis relied on their army of drivers and experience navigating regulatory avenues to preserve their business model. Sometimes lost in the heat of battle over whether TNCs should be subject to the same regulations as taxis are important insurance implications that need to be addressed. However, the insurance industry diligently worked to keep consumer protection front and center.

Faced with the competing interests, city after city, state after state has struggled to find the best way to balance regulations and ensure adequate consumer protections. Because there is very little in statute dealing with TNCs, the National Association of Insurance Commissioners (NAIC) and more than 20 state insurance departments and public service commissions have issued consumer alerts or advisories highlighting the potential insurance gaps in coverage for TNC activity and encouraging TNC drivers to talk with their insurers to understand their exposure.

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The mortality rate in Massachusetts declined substantially in the four years after the state enacted a law in 2006 mandating universal health care coverage, providing the model for the Affordable Care Act.

In a study released last week, Harvard School of Public Health professors Benjamin Sommers, Sharon Long and Katherine Baicker conclude that "health reform in Massachusetts was associated with a significant decrease in all-cause mortality."

The authors caution that their conclusions, published in Annals of Internal Medicine, may not apply to all states, and other studies have shown little correlation between having insurance and living longer. Nevertheless, the Harvard study adds to a growing body of evidence that having health insurance increases a person's life expectancy.

Mortality rates – in this case, the number of deaths per 100,000 adults between the ages of 20 and 64 that occur in a given year – vary widely among states. Mississippi, Alabama, West Virginia, Oklahoma, Kentucky and Louisiana have the highest age-adjusted rates (which recognize that some states have older or younger populations). Hawaii, California, Connecticut, Minnesota, New York and Massachusetts have the lowest mortality rates, according to 2010 data (the most recent available) from the U.S. Centers for Disease Control and Prevention (CDC).

Uninsured rates also vary widely. Between 2011 and 2012 Massachusetts had the lowest uninsured rate in the nation at 4 percent of its population, compared to a national average of 15 percent, according to a Kaiser Family Foundation analysis of U.S. Census data. Texas had the highest rate at 25 percent, followed by Nevada (24 percent) and New Mexico and Florida (both 22 percent).

Massachusetts is also among the most affluent states in the nation, and it has one of the highest average education levels and ratios of physicians to residents, all of which lower mortality rates. Many other factors also affect the death rate of a state or regional population, including the prevalence of chronic diseases, obesity, climate and environmental hazards, smoking and drug and alcohol abuse, gun violence and occupational safety.

"It is difficult to compare one state to another when it comes to mortality rates," said Alison Cuellar, a health economist at George Mason University. "All the evidence points in the direction of health insurance increasing longevity," she said. "We just don't know the magnitude of the effect."

In 2002, the Institute of Medicine estimated that the death rate of the uninsured is 25 percent higher than for otherwise similar people who have health insurance. According to the study, 18,000 excess deaths occurred each year because 40 million Americans lacked insurance.

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As you age, your insurance needs change. While in your younger years you worry about protecting your property and income, protecting your assets becomes a higher priority later in life.

"Changes in your life can mean big changes in your insurance needs. A change in marital status, the birth of a child or a purchase of a home can all trigger a gap in your coverage. That's why (you should revisit) your policy at least once a year, or whenever you experience a big life change." says Jeff Reinig, head of personal lines underwriting from Farmers Insurance in Los Angeles.

Here, experts recommend the insurance needs to consider – and the gaps to avoid – as you move through different stages of life.

In your 20s and 30s

Experts say now is the time to set yourself up for the future.

Start by protecting your valuables, even if they are few to speak of at this point. Homeowners, condo or rental property insurance will cover the cost of replacing or fixing your belongings, and you should also protect unique and valuable assets, like that diamond engagement ring, for instance, with a floater on your policy.

Married or have children? Then you definitely need some form of life insurance. Consider term life insurance, a more affordable option at this stage. Term policies cover you for a specific length of time and pay only a death benefit. And plan to purchase group life insurance through your employer if it's offered. Another factor to consider when purchasing life insurance is your debt. More debt equals a higher need for life insurance.

Carpool? You should consider the liability impact of a car accident, especially if you're carpooling to work or driving your kids – and their friends – to practices. Ideally, your liability insurance will cover your assets in the event of a lawsuit due to a car crash.

In your 40s

The key here is your health and how it has changed or will change.

"You really do have to take a hard look at how much coverage … you want to lock in for the long term, because your health can start to go downhill and you want to make sure you don't paint yourself in a corner," says Cal Brown, market manager for Savant Capital Wealth Management in McLean, Va.

Remember, the less healthy you are, the more it costs to buy life insurance, and in some cases, you won't be able to purchase it at all.

Your income might grow, but so will your family's dependence on that income. You'll likely acquire more assets as well, so evaluate your life insurance and home insurance to make sure it's adequate. You – or your family – don't want to uncover a gap in coverage in case an unexpected accident occurs.

Keep in mind, your children also present an increasing risk as they start driving, going to unsupervised parties and doing other things that raise your risk. You will need to add your driving teens to your auto insurance policy, and experts recommend increasing your liability coverage to cover the potential cost of damages or injuries your kids might cause during this time.

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