The Underwriting File

by Guy E. Burnette, Jr., Esquire

There are many potentially significant documents in the underwriting file which should be reviewed by the investigator in any arson case. If the case is an arson-for-profit fire, the application and related documents used in the issuance of the policy may reveal fraud in the procurement of coverage - especially information about the size, age, condition and value of the property. Information about the applicant's loss history is another common area of fraud. The information about the ownership of the property and any mortgagees / lienholders or others having an interest in the property may be another source of fraud.

In addition to the application for insurance, the underwriting file typically contains a number of other documents which should be reviewed in any investigation. Those include:

• the agent's supplemental application form (basically an application submitted by the agent in conjunction with the application of the insured);
• the "rating sheet" which describes the property by its construction type, size, design and other features to establish the insurable value and the premium to be charged;
• appraisals or evaluation reports used to verify the insurable value;
• premium payment records;
• premium finance agreements;
• cancellation/non-renewal notices;
• credit reports;
• "Dun & Bradstreet" reports on an insured business which provide information about the operations of the business, its history, ownership, sales volume and credit rating;
• binders providing temporary coverage;
• loss control reports and other inspection reports on the physical layout of the insured property noting any potential fire hazards or hazardous operations;
• pre-loss photographs;
• diagrams;
• building plans or blueprints;
• information about other properties or coverages the insured has or previously had with the insurance company;
• correspondence and internal memoranda with the agent / broker or insured concerning the coverage
• and, if there have been any changes to the coverage originally provided, there will be records showing the reason for the requested changes and copies of the "endorsements" to the policy making those changes

Obtaining and reviewing the underwriting file should be routinely done in all investigations and particularly those involving suspected arson-for-profit. In order to obtain the underwriting file, it must be requested from the insurance company through the appropriate office. The underwriting file is not contained in the records of the insurance agent and cannot be obtained there. Similarly, it is not in the possession of the claims office of the insurance company. Underwriting is a separate division of the insurance company and the records must be requested directly from that division, usually in the regional office or home office of the insurance company.

Reprinted with permission from the author.