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How to Analyze Insurance Documents in a Fire Investigation:
The Homeowner Application

by
Joseph Toscano
VP, Fire Investigation Specialist
American Re-Insurance Co.

The information on an insurance application contains important facts about both the insured party and the insured property as the insured represented it and the agent observed it. The application should be closely reviewed for all available information and analyzed for consistency with statements made to you, the investigator, and facts known by you. The form of the application may differ slightly depending on the type of policy and the company, but, in general, the analysis of the application provided below will be helpful in your investigation.

Annotations are found below the form. You may click on any number on the form to hop directly to its annotation.

1. The date of the application may be significant in relation to the date of the fire. For example, you may find that insurance was applied for close to the date of the fire.

2. The producer is the agent who received the application from the insured and should be interviewed at the early stages of the investigation. See Interacting With Insurance Representatives for more information on the agent.

3. The effective date and expiration date establish the period of insurance coverage requested at the time of the application. You may find this information relates significantly to other facts you have found in the case, i.e., that the insurance expiration date was nearing at the time of the fire.

4. The applicant information contains facts about the person applying for the insurance. Here, you may find discrepancies with what the insured has told you that may bear on the case.

5. The length of time of acquaintance with the applicant may establish a personal or professional relationship between the applicant and the agent. This information is provided by the agent.

6. If the agent has ever inspected the property, it is shown here. In many cases, the agent has never seen the property. If the agent has, he/she might be able to provide important details and observations about the pre-fire conditions and characteristics.

7. The amount of insurance coverage applied for is stated in this section. It may be relevant to the investigation in a case of fraud. You may note discrepancies here between the statement given to you by the insured and the facts of the policy applied for.

8. The rating/underwriting information can be important to the fire origin and cause investigation, as well as the investigation of a potential arson-for-profit. Here, you can find quite a bit of information, including details of building construction, market value, occupancy, and building classifications. Any of these may point out inconsistencies with information you have observed or developed that require further investigation, such as why smoke detectors were removed or when a heating system was converted.

9. The answers to these informational questoins are important to the underwriting decision and may be particularly important to an arson investigation. Where information has been deliberately misstated or omitted, it may point to an insurance fraud fire.

10. Loss history may point to an insured who has previously collected insurance proceeds and is aware of the potential for profit. An undisclosed loss history may be part of an insurance fraud plan.

11. Prior coverage information may lead to the discovery of prior claims or a significant change in the type or amount of coverage.

12. The identity of others with an interest in the insured property may point to significant indebtedness or difficulty in meeting financial obligations.

13. The remarks section may contain other information used in considering the application, usually filled in by the agent.

14. The application may include a binder providing temporary insurance while the application is under consideration. A loss occurring under a binder, especially in a property where the appliation might not have been approved, may be a significant fact in the investigation.

15. The signature of the application is direct proof of the source of the information and generally establishes its amissibility as evidence at trial.

16. The date of the application may be important in the context of the timeline of events leading up to and following the fire and in the overall investigation.

17. The signature of the producer (agent) identifies the key witness for proving the authenticity of the application and the information provided by the applicant.

Reprinted with permission from the author.

 
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