My auto claim was referred to as Special Investigation

by wrm1973 » Wed Jan 01, 2014 08:39 pm

I have a few questions regarding an incident that we were involved in a few weeks ago. On Dec 21, we were on our way back to my Mom's house from shopping, driving Southbound, and two tractor trailers hauling timber were traveling Northbound. There was a curve in the road, in which the trucks were leaning in toward our car. The weather was terrible, and as the trucks passed us, material from the trucks pelted the driver side of our car causing several dents along the drivers side of the car. In addition, the debris also hit the undercarriage of our car, causing the airbag light to start blinking. There was no safe place to pull off the road, as there was heavy rain (over 3" of rain that day) and we were only a few miles from home, so we continued home and took a look at the car once the weather cleared, which is when we found the damage. I signed on to my insurance carriers website 3 days later to report the damage, only to find that our insurance policy canceled less than 24 hours prior to my signing on the website (December 23). I spoke with an online chat representative to inquire about the canceled policy, as I was not notified, and that we were in another state visiting my Mom. Prior to all of this, I had spoken with a few representatives, and all they said was that a payment was due on Dec 23, and made no mention of our policy canceling. I explained all of this to the claims representative who took the loss report. They had an adjuster come to my Mom's house to run an estimate and we then took the car to a garage to inspect the mechanical damage. I then receive a voicemail from the adjuster yesterday saying that because I filed this claim a day after the policy had canceled, that there were a "few questions" that needed to be asked, then they could proceed. I tried to reach back out to her, but she was unavailable. I then called her supervisor, and explained the above to him. He said that it all made sense and that he would note our conversation for the "Special Investigation" representative, and that it should be settled no later than the end of the week. Not knowing what a "Special Investigation Unit" is, I looked this up on the internet and come to find that this department investigates fraudulent claims!? Needless to say, this made me extremely upset. I have done nothing wrong, and for my insurance company to accuse me of something like this was again - very upsetting. The adjuster said that they just wanted to clarify why my policy canceled, and then filed a claim less than 24 hours following the cancel time. But the fact that I explained that to everybody I had communicated with, why are they accusing me of any wrongdoing when I had no idea that our policy had canceled?

With respect to this call that I am supposed to receive from their "SIU", what is the protocol? What should I expect? Do I need an attorney? Can I sue the insurance company for defamation of character? I am completely outraged. Any help would be very much appreciated.

Total Comments: 8

Posted: Wed Jan 01, 2014 10:27 pm Post Subject:

You knew about the accident and damages... why would you wait 3 days to report it to your carrier?

Now you know as well as anyone that the damage _could_ have occurred after the policy cancelled and that there is no real good reason for waiting 3 days to report an accident. But you don't think anyone should even ask any questions about this? You claim that your insurance accused of doing something wrong... but did they really? In your post you never mentioned that they actually accused you of this. But again, you know as well as anyone that this is a valid question. In the real world people defraud insurance companies like this all of the time.

Why not save the outrage until you actually suffer some damages, like the insurance company denying the claim. Until then, they are 100% within their rights to investigate the claim... any claim. In this case, especially so.

Posted: Wed Jan 01, 2014 10:41 pm Post Subject:

Again, I had no idea that the policy cancelled until the day I logged into my account to report the damages. In addition, I have receipts showing where we were, etc. on the day of the damages occurred. In addition, I had communicated with the company several times prior to this cancellation date, and at no time did the mention anything about the policy cancelling, otherwise I would have certainly taken care of whatever the payment was to avoid cancellation.

So in your opinion, they will not honor the claim because of a cancellation that I was not made aware of?

Posted: Wed Jan 01, 2014 11:28 pm Post Subject:

Again, I had no idea that the policy cancelled until the day I logged into my account to report the damages



Not really relevant to the post but:
1) You should know that the policy expires
2) Your insurance company sent you a renewal notice
3) Your insurance company sent you a cancellation notice.

In addition, I had communicated with the company several times prior to this cancellation date



About the accident? You states that the accident happened on 12/21. You then states this:

. I signed on to my insurance carriers website 3 days later to report the damage, only to find that our insurance policy cancelled less than 24 hours prior to my signing on the website (December 23).


So it appears that you did not communicate with your insurance company prior to the policy cancelling. (it cancelled on 12/22 and you signed on 12/23. I'm guessing you are saying that you communicated with your carrier prior to 12/22 and they never mentioned the cancellation? It would have been nice but I guess it depend why you were calling and if this would cause the person to review the cancellation date or to know that you wanted to renew the policy.

So in your opinion, they will not honor the claim because of a cancellation that I was not made aware of?


According to your post, the accident happened on 12/21 and the policy cancelled on 12/22. If this is correct then as long as your carrier cannot show that the accident happened on 12/22 or later, then it should be paid (as long as you have comprehensive and/or collision coverage). It seems to be what the carrier is looking into is that the accident could have occurred on 12/22 or 12/23, after the policy cancelled. It's probably their policy to report all of these situations to their SIU dept.

Posted: Wed Jan 01, 2014 11:38 pm Post Subject:

I appreciate your help and feedback, I truly do. My communications with the company were at the beginning of December, and on 12/13 when I added the new car. The next time after that was on 12/24 when I logged into report the damage, and at that time is when I found out that the policy cancelled on 12/23. The policy was in effect through 2/1/14. The policy was cancelled for non-payment. But as I said, I am visiting my Mom, have not received my mail, and in the times I spoke with the reps in early December and on 12/13, neither rep mentioned cancellation on 12/23... just that a payment was due on 12/23.

My only proof is the receipts that I have from when we went to the store in town on 12/21. We didn't drive again until 12/26. I've read horror stories about these "SIU" departments, making everybody out to be a criminal. I'm certainly not trying to take advantage of the company, and this damage did indeed occur on 12/21. Now that this is referred to the "SIU", does that mean they will deny the claim? Do I withdraw the claim? I am just so frustrated that the reps I spoke with would fail to mention something like a policy cancelling.

Again, I've never been in this situation before. And again, I do sincerely appreciate your guidance.

Posted: Thu Jan 02, 2014 12:04 am Post Subject:

I've read horror stories about these "SIU" departments, making everybody out to be a criminal


An SIU dept _only_ becomes involved with a claim when it's suspect. As such I doubt anyone would have any heart warming stories about their investigations.

Do I withdraw the claim?

If it's valid I don't see why you would. As mentioned, the insurance company has every right to investigate a claim (it's actually required by law) and certainly when their is an issue of coverage.

An investigation does not mean the claim won't be paid. It simply means just just... it's being investigated. Certainly you understand that the claim was not reported when it happened (you wanted 3 days for whatever reason) and it was not reported until after the policy expired. A lot of people attempt to claim an accident occurred before the policy expired when actually it happened afterward. They are simply investigating this situation. It's prudent business and required of the insurance company.

Posted: Thu Jan 02, 2014 12:18 am Post Subject:

Again, thank-you for your guidance!

Given my circumstances, what types of questions will they be asking? I spoke with the supervisor of the adjuster who wrote up the estimate and explained the situation that we have been discussing, and he was very understanding, and he said that he would forward our conversation to the SIU representative in advance to assist in expediting the process. He told me to explain to them exactly what I explained to him. I just don't want this SIU representative to think that I'm trying to defraud the company, because that is most certainly not the case. Also, I waited 3 days because of the holiday, had a lot going on. And the fact that there were no injuries in the incident, I didn't call right away. So on the 24th, I happened to have some time to spare and take care of this and report the damage, not even knowing that the policy had cancelled.

Posted: Thu Jan 02, 2014 12:53 am Post Subject:

I just don't want this SIU representative to think that I'm trying to defraud the company


That is what they get paid to think. But this does not mean the claim is not valid or that they will deny the claim. An insurance company would need to have proof of fraud before they could deny a claim... not just suspect fraud.

I waited 3 days because of the holiday, had a lot going on. And the fact that there were no injuries in the incident


Seems reasonable.

Posted: Thu Jan 02, 2014 12:56 am Post Subject:

Thanks again for your help. Hopefully will get this all sorted out and resolved tomorrow. Will let you know of the outcome. Have a happy New Year!

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