Fighting Fraud

Aug. 31, 2015
Refer to the following recommendations to enable your shop to spot fraud and form business solutions that help customers, insurers, your shop and the industry at large.

Estimators and customer care associates represent the front lines of your business. How would yours address the following scenarios:

Scenario 1: After reviewing an estimate, the customer claims your shop has overlooked additional collision damage. That damage, to your estimator, appears to be unrelated to the accident in question. It's not uncommon for shops to encounter customers making similar claims, which can be immediately countered and resolved. This case is different. This customer won't back down. There's a small chance the damage is related to this claim, and the customer is demanding you take her side against an insurer who is balking at her claim.

Scenario 2: While performing damage analysis, your estimator encounters evidence the vehicle may have experienced serious water damage, perhaps as part of a recent flood in your state. This is a new occurrence for your shop, one that could carry serious financial repercussions. The customer wants to know how to proceed and what his insurance will cover.

Scenario 3: Your estimator is inspecting a vehicle with a moderate hit to its side and uncovers some previous repairs that fall well below standards and could compromise the vehicle's safety. The insurer wants more information on the repairs, and the customer is worried about how this discovery will affect his claim. You need to get answers for both quickly.

These aren't everyday occurrences for most shops, but they represent challenges for which your shop should have a plan. More significantly, they present opportunities for your business to help sniff out potential fraud and protect your business and the repair industry's good name.

Refer to the following recommendations to enable your shop to spot fraud and form business solutions that help customers, insurers, your shop and the industry at large.

Flooding facts

In 2012 Hurricane Sandy slammed into the Northeast Atlantic region of the U.S., carrying with it high winds and torrential rains that spilled into 15 states. According to the National Insurance Crime Bureau (NICB), storm damage claims were filed on more than 250,000 vehicles (150,000 just in New York state). Thousands more uninsured vehicles also probably were damaged. Damages ranged from paint scratches to vehicles that ended up under water.

Being submerged isn't the end of the driving life of many vehicles. CarFax estimates that more than 212,000 flood-damaged cars are on the road today, many of them from Hurricane Sandy. CarFax says statistics show half of the cars damaged in floods are resold after being cleaned up, frequently by dishonest retailers who never notify customers.

Flood damaged vehicles are a major headache for consumers, insurers and the automotive retail and service industry. Damage from flooding is relatively easy to conceal since it destroys vehicles from the inside out, eating away at electronics and vital engine components. Typically, owners don't discover the awful truth about these vehicles until they begin breaking down and a technician has the chance to examine them.

Locating flood damage is one of the greatest services you can perform for a customer. Not only does it head off potential disasters caused by compromised safety and control systems, but doing so also helps customers resolve a serious issue sooner.

(Photo courtesy of Property Casualty Insurance Association) Thousands of fllod damaged vehicles are sold to unsuspecting motorists every year, creating headaches for insurers, motorists and shops alike. (Photo courtesy of Allstate) Insurers often send reps to speak directly with customers with complaints over their estimates. Shops can help both sides reach an agreement.

Use the following steps during damage analysis to locate flood damage:

Step 1. Note any unusual corrosion, specifically rust, occurring in areas where moisture isn't typically an issue or rust not consistent with a vehicle's age.  

Examine the paint near chrome or rubber for bubbles, which indicate rust hiding under the paint. Look for corrosion on trunk brackets or latches under the dashboard. Pay special attention to door hinges and screws, along with areas where the door meets the body, including the bottoms.

Also check for rust on the vehicle interior and undercarriage, especially on the springs beneath the seats.

Step 2. Examine the interior. Obvious indications of flooding include grass, mud and silt under the seats and in the glove compartment. Also look for loose-fitting or mismatched carpeting or upholstery (mismatched based on color and age), which are signs that they have been replaced. Note too if the shape of the interior is consistent with the vehicle's age. An eight-year-old vehicle with a like-new interior should raise suspicions.

Inspect the entire interior, seats included, for brown, blotchy water stains. Note any musty odors or indications of mildew. If the upholstery looks fine, but you still suspect water damage, try running your hands along the carpet to locate moisture. Pat areas that appear or feel damp. If the carpet has pulled away from the vehicle, peel it back and feel it for moisture. Look for any rust.

Step 3. Test the electronics. Note any malfunctioning exterior, interior or dashboard lights, along with the stereo, A/C, heater, power outlets or windshield wipers. Look for warning lights, particularly those indicating problems with the airbags or ABS. Finally, look under the dashboard for any brittle wires.

Step 4. Examine the trunk and wheels. Check the trunk carpet for moisture and water marks. Remove the spare tire and check that area for any moisture.

While the vehicle is on a rack, examine the brakes and wheel components for mud and silt. Check the underside of the vehicle for flakes and other signs of excessive corrosion.

Not every vehicle that visits your shop will need this level of examination for water damage (though it pays to be vigilant if you work in or near an area subject to flooding). According to Allstate, most evidence for flood damage is easy to spot and usually turns up during a typical inspection. The object here is spotting the more obvious signs and then looking for additional evidence to corroborate your suspicions.

From there, you'll need to determine the extent of the damage. That will involve a thorough inspection of the engine since the most expensive, critical damage usually occurs there.

Estimating challenges

After identifying a flood-damaged vehicle, you'll have to inform both the customer and the insurer. Since you're dealing with a vehicle that probably was sold or titled dishonestly (not titled as a salvage or flood damaged vehicle as the law requires), all sorts of complications will set in.

First off, the insurer won't be responsible for the flood damage since it was incurred before the current owner took possession. Repair costs of that damage, according to Allstate spokesperson Justin Herndon, could force the insurer to total out the vehicle. Helping drive this possibility is the fact that flood damage drastically lowers the vehicle value (by as much as 75 percent)—making it a more obvious candidate for totaling and decreasing the amount the insurer pays out.

In short, you'll be dealing with a customer who's going to receive some bad news. Because insurers handle these situations on a case-by-case basis, both you and the customer will be left waiting for a decision on what work is covered, if any can be done.

This decision will have to be worked out between owner and insurer, but there are some things you can do to help. First, share any information you have and prepare customers for some potentially bad news. Also, offer any solutions you have for repairs they may have to cover. Finally, since so many of these situations must be resolved in the courts with fraud charges against the vehicle seller, it doesn't hurt to be able to recommend an attorney.

(Photo courtesy of GM) When searching for flood damage, always check the trunk for water and silt rapped near the spare tire and in other spaces. (Photo courtesy of GM) Examine carpeting and areas under the seats for water stains, dampness and rust.

Rotten repairs

Mike Walker, South Euclid location manager for 2014 Top Shops winner Mayfield Collision Centers, rarely sees flood damaged vehicles at his Northeast Ohio shop. He does see something similar—vehicles with previous repairs that are substandard, even dangerous. These repairs can affect current work since they can interfere with new repairs or may need addressed to ensure the vehicle is safe and roadworthy. Insurers, again, will evaluate their financial responsibility on a case-by-case basis.

One of their chief concerns is determining whether the policyholder had knowledge of these repairs or approved of them. Walker says that most customers, fortunately, own up to any responsibility they may have. "They usually tell you right away what they know," he says.

This kind of admission can result in the customer having to cover some repair expenses, but the important thing here is that honesty speeds the insurer's decisions, meaning that work can start on the vehicle sooner. Everyone involved benefits.

Tough complaints

Honesty also is at the heart of settling some common customer disputes raised during the estimate—namely, disagreements over what constitutes damage on the current claim.

Most shops eventually have to deal with customers who declare their estimate ignores additional damage created during the collision. Walker says Mayfield helps head off these problems by walking every customer through the estimate, giving them both the time to understand the repair and opportunity to raise questions.     

"We take the time to explain our findings and why the insurer might dispute anything additional," he says. "That usually solves most of these issues."

In rare instances, some motorists aren't satisfied and continue to pursue their claims. Herndon says Allstate prefers to handle these cases directly. "We would either set up a drive-in appointment or send an auto technician to the body shop at which time the shop would discuss the concern with an Allstate auto tech," he explains.

In some of these cases, insurers speak directly with the claimant. Walker says shops also can lend a hand here to create a resolution. Mayfield preps customers by reviewing the kind of questions the insurer will most likely ask and explaining the information they'll need.

There is that small minority of customers who will attempt to defraud an insurer with claims they know to be false. Shop integrity and a firm focus on evidence should stop these fake claims in their tracks. By offering them support, customers with legitimate concerns who receive disappointing decisions from insurers come away from the experience knowing the shop did all it could to help.

Unfortunately, fraud anywhere in the automotive industry creates many victims. Shops can do their part in fighting it. That starts with professional estimating and customer care centered on open communications and honesty. 

(Photo courtesy of GM) Flood damage is easily disguised and destroys vehicles from the inside out. Once you've spotted evidence, the engine will need to be thoroughly inspected.

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