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CHILDREN BITTEN BY GRANDMA’S RAT

VN:R_U [1.9.1_1087]
+1 (3 votes)

We received a homeowners claim for medical payments. A grandmother, who is the homeowner, was babysitting a neighbors kids along with her grand kids. She let them have a big slumber party in her basement. She had pet rats in cages that she has had for years. The kids of course got all the rats out and played with them even though they were not supposed to. The lost one of the rats and looked and looked but could not find it. Because they did not want to get in trouble they did not tell anyone the rat was missing. The next morning they all woke up with multiple rat bites. We now have been presented claims for the medical bills. I cannot believe none of the kids that were bitten dd NOT wake up. The doctor is watching their conditions closely as they may have to all get rabies medication.

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Another Fraudulent Claim

VN:R_U [1.9.1_1087]
+3 (3 votes)

Claimant fractured her arm in a fall on stairs. She claimed that the stairs didn’t have the proper tread and that our insured restaurant was negligent. There were no video cameras in the stairwell and so we thought we’d have to pay the claim. Then, she broke up with her boyfriend. He called us and told us that she was taking pictures with her phone when she fell and he provided us with the pictures and a text from her telling the story. We denied the claim and then referred the case to the state fraud department.

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BOSS RAN OVER MY FOOT

VN:R_U [1.9.1_1087]
+3 (3 votes)

I took this recorded statement. “I work along side my boss out in the field everyday. We get along great unless he is fighting with his girlfriend which means there are numerous telephone calls everyday with screaming matches. We install cable lines for Tvs. and telephones for a local company. Three weeks ago he was fighting with his girlfriend and did not realize where I was standing and backed over my left foot. He stopped when he heard me screaming and put it into gear and drove back over it.

I thought it may be broken but I was not sure. I just knew I was in a lot of pain. He profusely apologized to me and then begged me not to report the injury as he was already on probation for multiple infractions. I hobbled around for a few days over the weekend and then he brought me his brother in law’s BOOT from when he had bunion surgery. I wore the BOOT while out on jobs to give me stability. But, my foot pain was out of control and I couldn’t take the risk any longer. I realized my health was more important than my relationship with my boss. At the end of the day I called the district manager and told him what had happened. He was shocked and sent me to the ER right away. My foot required immediate surgery and had to be casted. When I was finally released home my boss called and cussed me out. He was fired for me reporting the injury. I apologized but told him that I thought he was being selfish as I was the one in pain.

I cannot prove it but since this happened my mail box has been runover twice, my car was keyed and my tires were slashed. Just bought a nanny cam to try and catch this jerk playing retaliation.

Will my settlement cover the pain and suffering caused by my boss?”

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MUSHROOMS GROWING THROUGH HER CARPET

VN:R_U [1.9.1_1087]
+3 (3 votes)

A homeowner submitted a claim for water damage to her upstairs bedroom and bathroom, stairway and hallway. They alleged the leak was only discovered after the claimant discovered mushrooms growing through her carpeting. She took pictures and emailed them to me and she had about eight large mushrooms growing out of her carpet. After she took the pictures she ripped out all of her carpeting and padding and had to rip out quite a bit of carpet as the area attached with her stairwell. She was not happy to hear that we denied the claim as it was a leak that had occurred over time and our policy does not cover leaks that occur and are not reported within seven days.

Even though the leak was allegedly not discovered we have to wonder if she was just letting it go to make sure she had a claim to replace all of her carpeting throughout the entire upstairs of her home. She cussed me out but I had the last laugh thinking of her moldy mushrooms.

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Hanging Leg

VN:R_U [1.9.1_1087]
+3 (3 votes)

Claimant injured his leg severely in a car accident and filed a lawsuit against the other driver, our insured. We couldn’t understand how his leg could have been so severely injured until the driver of a car following the Jeep Claimant was riding in gave us the video from his car-cam. It showed Claimant’s leg hanging out of the Jeep immediately before the accident. We reduced our offer and claimed that he was partially to blame for his severe leg injury. We settled for a reasonable amount.

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Implant Scam

VN:R_U [1.9.1_1087]
+3 (3 votes)

Claimant alleged that our insured, a dentist, was negligent in implanting a tooth. She claimed she had pain and numbness since the implant and demanded her money back. She threatened the dentist with a malpractice suit. We did some research and discovered that with each implant Claimant had received, she’d demanded her money back and used that money to fund more dental work. We denied the claim

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No Finger Left for that Precious Ring

VN:R_U [1.9.1_1087]
+3 (3 votes)

We had another claim involving an injury from one of those high powered smoothie blenders with a ferocious blade. The claimant reached in the blender to get her wedding ring that slipped off when she was dropping some banana slices in it. She was so focused on her ring that she forgot about the blade. And, the blade almost severed her ring finger! Our insured is the company that manufactures the product. We provide plenty of warnings and it’s not the company’s fault she was careless. We denied the claim. She’ll likely sue.

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MUSLIM ALLEGES RACIAL DISCRIMINATION AND HARRASMENT POST TERMINATION

VN:R_U [1.9.1_1087]
+3 (3 votes)

The claimant alleges he worked for his employer for 10 months, during this time his boss and co-employees were constantly making discriminatory remarks about Muslims and harassing him about his daily prayers and fasting.

He alleges that one time a company-subsidized meal, that varied on a daily basis, was provided daily was actually pork but his boss convinced him it was chicken. The meat was actually pork, which those who practice Islam are forbidden to eat. He stated his boss immediately began laughing and mocking him when he was half way through the meal.

He also engaged in daily prayers and states that his boss allegedly told him, “don’t do that sh-t … this is the United States, not Saudi Arabia!”
Another time when he was fasting for a holiday he alleges his boss ranted, “Allah wants you to be hungry,” and called him stupid.

He has since been terminated and alleges his company ignored his complaints and now he is filing a Federal Post termination claim. We did a complete AOE/COE investigation and could not find anyone to back up his allegations. We are awaiting their witness list to make sure we are not surprised by an unknown witness.

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