"That's the hope, that when we do catch them, they will learn their lesson and not try to do it again. That's the dream."

-Teresa Durrant, Supervisor, Farm Bureau Insurance's Special Investigations Unit

May 26, 2020

Farm Bureau Insurance's Special Investigations Unit is Teresa Durrant, Supervisor (top), and Asenath Tubbs, Investigator (bottom)

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By Mike Myers

Things just weren’t adding up to what the insured told the Idaho Farm Bureau Insurance adjuster. The customer said that two days before, his truck slid off an icy corner, went down an embankment, and hit some trees. But when the adjuster went to inspect the truck, snow drifts had built up around the hanger where it was stored. This was strange because it hadn’t snowed much lately. He also didn’t notice any fresh tire tracks leading up to the building. Finally, there wasn’t any moisture around the vehicle and the cab was dry, even though the windshield had been broken out. An uneasy feeling that this was a case of fraud made the adjuster reach for his phone and call Idaho Farm Bureau Insurance’s Special Investigations Unit.

 

WHAT IS THE SPECIAL INVESTIGATIONS UNIT?

Farm Bureau Mutual Insurance Company of Idaho’s Special Investigations Unit (SIU) is a division of the Legal Department. Created in 2018, its sole mission is to protect the company and policyholders from the effects of insurance fraud.

 

The cost of insurance fraud (non-health insurance), according to the FBI, is $40 billion per year. That means insurance fraud costs the average U.S. family between $400 and $700 per year in the form of increased premiums. Experts also estimate that fraud makes up 10% of all property-casualty losses. That translates into over $10 million of fraud each year committed against Farm Bureau Mutual Insurance Company of Idaho.

 

“The biggest portion of what the SIU does is investigate suspicious claims,” says Teresa Durrant, the SIU’s supervisor in Boise. Teresa worked as a multi-line field adjuster for Farm Bureau Insurance from 2011 to late 2018, when she accepted the job of putting together the SIU division. Before joining Farm Bureau, Teresa attended Idaho State University where she earned her Bachelors Degree in Business Management.

 

Asenath Tubbs, who also holds a Bachelors Degree in Business Management from ISU, makes up the rest of the SIU. Asenath worked in Farm Bureau’s commercial underwriting department from 2015 until 2019, when Teresa hired her as an SIU Investigator. Before coming to Farm Bureau, Asenath worked as an underwriter for Farmers Insurance.

 

Asenath investigates claims in the southeast part of the state from the Home Office, while Teresa supervises and investigates claims from Twin Falls to the top of the state. “Eventually we’d like to have three investigators across the state,” Teresa says. “We were planning to hire another investigator for north Idaho right about now, but that’s been pushed back until the pandemic settles down.”

 

TRAINING

Investigating suspicious claims required specialized training for Teresa and Asenath. A few months after Teresa was hired for the SIU, she attended the National Insurance Claims Bureau’s (NICB) Special Investigations Unit Academy in St. Louis. The week-long training included learning how to tell if someone is being deceptive when they’re talking with you, how to look at fire scenes and tell if an accelerant was used, and other investigative techniques. Asenath will attend the academy soon.

 

TOOLS

One tool the SIU added to help protect Farm Bureau from fraud was a subscription to the Insurance Services Office (ISO) ClaimsSearch database. “ClaimsSearch is a giant database of claims that the majority of other insurance companies also subscribe to,” Teresa explains. “Now when a claim is filed with Farm Bureau, the adjuster receives a Match Report containing the claimant's prior claim history with other carriers. The Match Report might show, for example, that the claimant already has multiple theft claims with other insurance companies, or they’ve been investigated by another company’s SIU. ClaimsSearch gives us more information about who we’re dealing with – before they ever came to Farm Bureau.”

 

TECHNIQUES

Other techniques the SIU uses to investigate suspected fraud are more hands-on. “We deep-dive in and follow leads, talk to witnesses, go to the scene and canvas, knock on neighbors’ doors, and do everything we can to find out exactly what happened and see if it aligns with what they’re telling us happened.”

 

RESULTS

Teresa and Asenath each investigate about 30 cases a month. “The majority of those are cleared,” Teresa adds. “We have a lot of really great insureds. Don’t get me wrong.” Those that aren’t cleared are forwarded to the Department of Insurance (DOI). “Even if we pay a claim, if we have enough red flags and enough evidence to say that it is very likely that fraud is being committed, we’ll refer a case to the Department of Insurance. The DOI then decides if they want to file criminal charges.”

 

The DOI’s website generates a report tracking the number of referrals each company makes. In 2016, Farm Bureau Insurance referred six cases. In 2018, after Teresa began her SIU job in October, Farm Bureau filed six cases in the last two months of the year. In 2019, Farm Bureau made 48 referrals to the DOI. “In 2020, as of April, we’ve made 21 referrals. These are numbers I can get excited about.”

 

Teresa adds that the DOI and the NICB both decide whether or not they want to file criminal charges. “Right now they have 17 open investigations into referrals we have made to them. Two of them are on the prosecuting attorney’s desk awaiting criminal charges.”

 

A CONVICTION FOR FRAUD

Last year, the SIU had their first fraud conviction. Teresa explains: “We had a claim that was reported as the theft of a vehicle. The insured said he was at a bar hanging out with a friend, and decided it was best if his wife came and picked him up. The next morning he was awakened by police telling him they found his vehicle wrecked and abandoned.” The car had jumped a curb a few miles away from the bar and hit some landscaping. “We started to look into it because the adjuster had some misgivings about it.”

 

Asenath paid a visit to the bar and obtained parking lot surveillance footage. “The footage showed the insured stumbling out to his car at the end of the night, getting in, and driving away.” The local police department charged him with insurance fraud and filing a false police report. “He ended up pleading to misdemeanor insurance fraud. Besides the fraud conviction on his record, he was also sentenced to community service.”

 

Teresa points out that, in this case, the only benefit the insured would have received if the SIU hadn’t discovered his lies was the claim would have been comprehensive instead of collision. “We insure poor judgement, we know that. We’re not going to deny your claim just because you admitted to drinking and driving. We’re not the police. Had the insured told the truth from the beginning, he would have avoided a criminal record. Hopefully he won’t lie again. That’s the hope, is that when we do catch them, they will learn their lesson and not try to do it again. That’s the dream.”

 

PUTTING A DENT IN FRAUD

Another recent case the SIU closed resulted in a claim not being paid. “The insured claimed a dent in their truck occurred after we insured it. Asenath tracked down where he bought the vehicle and talked to the dealer. The dealer shared time-stamped photos with us showing the truck with the dent in it when it was still on the lot. Because we could prove the dent was there before we insured the vehicle, it wasn’t covered under our policy, and the Claims department didn’t pay the claim.”

 

NOT GETTING SNOWED

The mystery of the snowbound truck turned out to be a similar case. “In that case, we found out the customer had wrecked his truck, emailed his agent the next day to add full coverage, parked his truck in the outbuilding for about a month, and then turned in a claim saying the wreck happened a month after it really had occurred.”

 

Solving this case was relatively straightforward.  “We opened a case after the adjuster called and told us his suspicions,” Teresa recalls. “It was a small town, and the truck had to be towed. The damage was bad enough that it totaled out the vehicle, so I called the sheriff’s office and inquired if the insured have been involved in any accidents the days prior to the vehicle being added to the policy.” It turned out the police had actually responded when the wreck occurred. “What actually happened was the insured slid into the back of a semi-truck hauling logs. The police made a record of the accident and took photos of the truck. So they had all the evidence we needed – luckily.” Teresa emphasizes that in this case, “it wasn’t denied because they tried to commit fraud, it was denied because the damages didn’t occur within our contract.”

 

CASES CLOSED

“At the end of the day we’re just trying to protect Farm Bureau and keep people honest,” Teresa says. “The insured gives a statement to the adjuster and says this is what happened, and sometimes it stinks to high hell. We’ll dig into it and investigate it fully, and then, if everything makes sense, we’re able to move on. I like it when that happens, because at least we’ve proved that they’re telling us the truth. That way we can pay the claim and move on with a clear conscience.”

 

A TIP FOR PREVENTING FRAUD

Teresa wants everyone to know they can help the SIU prevent fraud and protect Farm Bureau Insurance. “There’s an NICB tip link on Farm Bureau’s public website [under “Resources” in the homepage’s top menu bar.] If you’re not comfortable calling the SIU directly – if, for example, you suspect internal fraud and don’t want to get involved, you can use this link.” The NICB link is completely confidential. “The NICB forwards only what the tip actually is, and none of the information about who sent it. This gives us the opportunity to look into things that might be fraudulent, or might be fine, but at least it gives us the tipoff that maybe we should take a look at this.”

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