Forensic investigation of insurance claims related to large California earthquake
Forensic investigation of insurance claims related to large California earthquake
Retained by outside counsel for a Fortune 100 company to assist a major personal lines property and casualty insurance company to identify and analyze claims associated with the 1994 Northridge, California earthquake. The scope of the investigation focused on the company’s alleged hiring of fraudulent engineering firms in connection with homeowner claims associated with the 1994 Northridge, California earthquake. The investigation was in response to a FBI and DOJ investigation of allegations made against the company.
We worked closely with outside legal counsel and senior management to identify, analyze, and investigate approximately 50,000 catastrophe related homeowner claims. We gained an in-depth understanding of the company’s claims-handling process and the company’s information sources in order to identify claims that met the criteria established by the company’s legal team. Information was collected from various sources including over 150,000 hard-copy claim checks, company systems, and through the review of actual physical claim files. In addition, we developed electronic tools to search the company’s electronic claims diaries.We physically reviewed and analyzed entire claim files that met the established criteria. We captured certain agreed to data elements and information from the claim files directly into a database, using a customized installed electronic form. This information repository and the associated analyses proved to be a critical component in the settlement of class action claims.
We worked with counsel to identify the potential class participants based on the criteria negotiated in the class action settlement. Detailed questionnaires were developed and mailed to potential participants in order to determine and finalize the class. We were actively involved in all aspects of the ensuing class administration from controlling the questionnaire process to check remittances to class participants.