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.
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