Special Report on Fraud

December

 2 6

Y O U R G U I D E   T O   I N S U R N C E F R U D D E T E C T I O N  A N D   P R E V E N T I O N

  u s t e d

A Menace to Society

Four suspec ts w ere a r res ted fo r s tag -

ing an auto col l is ion r ing, dubbed Op erat ion

Phan tom Menace , wh ich a l l eged ly caused

more than 100 col l is ions in the B ay

 A r e a ,

 a nd

resul ted in more than $2 mi l l ion in losses to

insu re rs .

Norber to Ch i to D iaz Mo ra , the a ll eged

r ingleader , was arrested on   1 40   f e lony coun ts

involv ing insurance

  f r aud .

  Also arrested

were th ree ch i rop rac to rs : Dav id Wu ; Reza

A l iakbar ; and Marce l l o Mehmandous t Each

was charged v i / i th mul t ip le fe lonies re lated to

insu rance f raud ,

Mo ra a l l eged ly rec ru i ted peop le w i th

pol ic ies cover ing bodi ly in jury damages and

ins t ruc ted them to c rash the i r veh ic les

 in

staged or paper-scr ip ted col l is ions. The chi ro-

practors are a l leged to have knowingly b i l led

the v i c t ims ' insu rance compan ies fo r se rv i ces

never rendered .

The arrests were the resul t o f   a   tw o

year undercover i nves t iga tion conduc ted

by the Cal i forn ia Department of Insurance's

Fraud Div is ion and the Bay Area A uto Fraud

Task Force (BA AF F) . Two undercover

BAAFTF Invest igators in f i l t ra ted the r ing and

ident i f ied the suspects. Law of f ices and an

ai i to-bodv repai r shop a lso v i /ere found to be

involved in the r ing.

I f conv ic ted , the suspec ts w i l l be fi ned

up to $50,000 and/or receive f ive years

  in

pr ison or double the value of the

  f r aud ,

 w h i c h -

ever is greater .

Crooked Hearts

A pol ice o f f icer a l legedly s et an SUV on

f i re in order to get insurance money to buy a

Cadi l lac Escalade.

El izabeth Lauren Anderson,  2 7 w h o

jo ined the B runsw ick , M d . Po l ice De par tmen t

T h e B C s o f V e h i c u l a r

C o l l i s i o n R e c o n s t r u c t i o n

By Steven M Schorr

B u s t e d   I  p

0 2  I  D E C E M B E R 2 0 0 6 C l a im s M a g a z i n e

he analysis of a vehicular col-

lision involves applying of the

laws of physics to physical e\ i-

dence left as a result of a colli-

sion . Typically, this is co m ple ted in an effort

to determine bow

 a

 collision occurred. The

reconstruction analysis prov ides the special

investigative unit manager, claim manager,

investigator, and attorney with

 a

  founda-

tion

 of

 reasonable theories when presenting

or defending a case. Listed below are 26

reminders of items critical

 to

 the successful

utilization of a collision reconstruction engi-

neer in the analysis of a vehicular collision.

 

lways collect avaiiai:)le data as early

as feasible. The ability of any reason-

able engineer to accurately reconstruct what

l a g c o m

occurred during a collision is a function of

the available physical evidence. Data such

as t ire marks, debris, roadway scrapes, and

the resting pomts of objects involved in the

collision are often short-lived. More data will

be available for collection immediately after

an accident.

B

efore committing to

 a

 tbeory, recon -

struct how the collision occurred. All

credible theories will flow from the collision

dynamics. Attempting to evaluate the ments

of a case without first finding out wbat actu-

ally occurred or wbat could have occurred

could create problems,

I  om puter e are mvolved in all aspects

  of our lives. Talk to your expert about

 

what kinds of data the com puters compile,

how to retrieve it. and how it might prove

beneficial in the analysis of the collision.

Additionally, ask your experts how they

utilize computers in their analyses. It is hen-

elicial to be cognizant of the merits of such

usage.

 

ata is the foundation of the analysis.

Critical data includes the points of rest

of the vehicles, the damage to the vehicles,

the location and t) pe of d ebris left a s a result

of the collision, and the identification of the

point of impact area. This data is the foun-

dation of

 every-

 reconstruction analysis.

 

xperts may be necessary to help evalu-

a t e ,   present, or defend a case, but be

sure to utilize expens properly. For example,

just because an expert is an engineer does

not mean that he is an expert in all engineer-

ing areas. Typical disciplines incorporated

into collision reconstruction include vehicle

dynamics, the mechanical workings of the

vehicle, driver responsibility and perfor-

manee, traffic engineering/highway safety,

and human factors.

F

ollow the trail of the physical evidence.

Many times, the physical evidence

will yield early identification of the issues.

This identification allows for an evaluation

of the strengths and weaknesses of   a  case.

Be sure ihai all of the analyses and opinions

prolTered are based on the available physical

evidencc-

G

ather data empkning the three-

component thought process. There

are three components found in ever> col-

lision: the roadway, the vehicle, and the

B e s u r e t h a t a n e x p e r t

h a s k n o w l e d g e i n t h e

s p e c i f i c s u b j e c t a r e a

r e le v a n t t o t h e n e e d s o f

t h e c a s e

  a n d

  t h a t h is

e x p e r t i s e is n o t p e r ip h e r a l

driver. Without each of these three factors,

there would nol have been a collision.  se

these elements as a guide to data collection

througho ut all phases of discovery.

H

uman Element (the driver) is one of

the three co mpone nts in every colli-

sion. This categor) includes driver actions,

laiigue. impairment, distraction, training,

and qualifications. These disciplines are

typically addressed by the traffic or high-

way safety engineer and the human factors

expert.

I

nvestigate all possible data sources. This

includes the police investigation, newspa-

pers, stationary traffic ameras, surveillance

cameras, dash-mounted police camenis.

onboard computers, fire/rescue personnel,

independent photographers, witnesses.

Department of Transportation photographs

and video-logs, and vehicle htstor) data.

 

ack-of-all-trades,  Be   aware that one per-

son cannot be deem ed an expert in all

areas;

 there are specialists in   a l professions.

Be sure that an expert has knowledge in the

specific subject area relevant to the needs of

the case and that his expertise is not periph-

eral.  A   collision reconstruction expert can  be

an engineer, but an etigineer is not always an

expen in collision reconsiruction.

K

now your client, know your audi-

ence- As trial counsel, you need to be

sure that both the ability and personality of

your expert fits your case. An expert must

be able to complete the analysis in an aecu-

raie and professional m anner. The expe n

must be able to comm unicate his accurate

opinions to you, your client, and the co urt

in a persuasive and professional manner. Bc

B u s t e d   I  c o n tin u e d f ro m p . 4 2

in 20ffi, was taken into custody during a traffic stop. She was a pas-

senger in a vehicle being driven by another police officer, Randy Dorsey,

who had also been charged in setting an SUV on

 fire.

 Authorities said the

two police officers are dating.

According to authorities, ttie couple had been shopping for an

Escalade, signing a contract for one

  a n d ,

  after the arson, picking it up.

Dofsey was chargeti with second-degree arson and first-degree  mali-

cious burning, which are felonies. He is free on 30,000 baii, Anderson

was charged with the same crimes,

  a s

 well

  as

  fraud and conspiracy.

S o u r c e ;

  T h e C o a l it io n g a i n s t I n s u r a n c e F r a u d

Totaleil Recall

Thirty-three individuals were arrested for allegedly being involved

in more than a dozen staged acc idents and fraudulently billing

  11

 atrto

insurance companies nearly

  1

 million for treatment of non-existing  inju-

ries and auto damage claims, according to a release by  T om  Gallagher,

Florida's chief financial officer

According to the release, in the case dubbed   otaled

 Recall

sus-

pects purchased

previously damaged

used vehicles for

staged accidents.

According to inves-

tigators, tow truck

drivers w ould trans-

port

 t h e

  inoperable

vehicles to a crash

site and then wait for the police to finish their reports   so  they could tow

the same vehicles away. Several body shops allegedly caused addi-

tional damage to vehicles in order

  to

 submit inflated

 claims.

 The release

reports that the accident organizers collaborated with clinic owners and

targeted the personal injury p rotection (PIP) insurance of drivers, billing

each patient's insurance company

  10,000.

 Florida law requires drivers

to carrv at least  10,000 in PIP coverage and 10,000 in property damage

liability coverage.

Gallagher's office reports that th e  arrests followed  a two-year

investigation, and that   14 of the suspects face a minimum two-year

prison term if

 convicted.  •

4 4 DECEMBER2 6 ClaimsMagBzine  wwuvc la imsmag.com

 

•̂ .ure Ihat yo ur cx pe n ca ti prov ide you wit h

siaie-of-the-arl techniques in analysis and

presentation if the case and foram warratit

such presentation.

L

aws of Physics are applicable to all

asp ects Lif a collision . Any an d all ana l-

yses must be grounded to theses fundamen-

tal principles. In doing so, the credibility

of your theory and of the testimony of the

involved parlies or witnesses can be evalu-

ated. Be sure that your expert is well-versed

in physics and has the ability to explain the

concepts in a clear and understandable man-

ner to the layperson.

M

ake sure your cxpen has siate-of-ihe-

an lechnology and research available

Io him. This not only allows for a more

complete and accurate foundation of data,

but It potentially leads lo a more-detailed

analysis along wlih more possibilities for

demonstrative evidence. The util ization of

staie-of the-an technology durin g the analy-

sis often lowers the cost of demonstrative

evidence, too, since the exhibits already have

been created as pan of the analysis process.

ice pictures can be impressive.. .but

are they accurate? Be sure that you r

v isual evidence is accurate an d unim peac h-

able. Conversely, be sure thai your oppo-

nents demonstrative evidence is substantive

  fluff.

tion is an engineering process: the same

precision utilized for the analysis must be

employed in preseniing it .

D

pen-minded appraisal of the available

data is necessary to fairly evaluate a

case.

  If you have an understanding of the

strengths and weaknesses of your case, i t

will be easier for you to see how a jury may

view your case. Do not allow yourself or

your expen lo reach any opinions until the

data is properly evaluated.

P

roject how you are going to present

your case. The order of your wit-

nesses may allow you lo systematically and

smoothly build the loundation of data that

your expert will rely upon to render his

opinion. It aLsn will allow you to portray to

ihe ctiurt ihe reasonable approach utilized to

reach your conclusions and opinions.

 

uestion your expert . Question your

theory. Your job — and the job of

the expen — is to evaluate all aspects of

ihe collision so that you are cognizant not

only of your case, but also of the strengths

and weaknesses of the opposing expert and

counsel. Do not underesUmate the need and

usefulness of this.

oadway issues are one of the three

components found in every collision.

This category includes roadway design ele-

ments such as roadway geometry (curves,

grades, and super-elevation), traffic controls

(signs, striping, signals, and appurtenances),

T o b e c r e d i b l e t b e   t e s t im o n y

m u s t   b e   c o n s i s t e n t   n o t   o n ly

w i t b

  t h e

  a v a i la b l e p h y s i c a l

e v i d e n c e b u t

 a l s o w i t h

  t b e

l a w s

  o f p b y s ic s .

pavement properties, construction, mainte-

nance, and work zones. These areas typically

are handled by the traffic or highway safety

engineer.

S

ecure the vehicle if you have any

thoughts that a defect or other type

of problem with the vehicle might prove to

be an issue. Whenever possible, secure any

other item that may be a factor in how the

collision occurred.

T

estimony may be an imponant part of

your case, but care must be taken to

remember that i t is not physical evidence.

Testimony should be collected util izing

(he three-co mpo nent though t process as a

guide. To be credible, the testimony must

be consistent not only with the available

physical evidence, but also with the laws of

physics. People s views and mem ories of an

occurrence are sometimes fallible: physical

evidence does not l ie.

U

nderstand your expert . Make sure that

the analysis is clear and believable.

If you cann ot un derstan d or believe your

expen. just think of ihe problems that he

will have convincing a juro r or cou n of the

value and veracity of the analysis.

V

ehicle issues are another of the three

components in every collision. Vehicle

issues include mechanical p erfonn ance,

crash worthine ss, occu pant restraints (seat

belts,

  air bags, and seatbacks), fire cause

and origin, onboard computers, and overall

vehicle m aintenan ce. These issues typically

are handled by the reconstmction engineer

or automotive engineer.

W

ait, if possible, before taking deposi-

dons and finishing discovery until

you talk to your expert . He may enlighten

you to additional data that can be obtained

through dia^overy (induding testimony) that

would prove beneficial in the reconstruction

analysis.

amine the procedure employed

by your expert. Be sure that you

understand the scope of the expert analysis,

what data will be required to complete the

analysis, the process the expen plans to uti-

lize to complete the anaiysis. and the general

cost of the expend work. The more you are

cognizant of the variables required for the

expert analysis, the better your chances of

not being surprised by the results or the bill.

Y

ou are the general contractor. The

expen is a sub-contractor. You must

know and unders tand what your exper t

has accomplished and how his opinions

conform to your theory and the opinions

of othe r experts involved in y our case. Your

case is only as strong as its weakest link.

ero tolerance must be ^ven to any vari-

able that is known to be unethical or

inaccurate. The evaluation of the available data

and applicable theories must be completed

with the highest regard br pn:cisi()n. The

attorney and expert should have zero toler-

ance for criteria that does not m eet the highest

mor al, ethical, and scientific standarcis. •

Steven M. Schorr P E President of D JS

Associates Inc. is a nationally renowned

expert in the areas of Acciden t Investigation

and Recon strtjction Highway Safety and

Traffic Engineering. He may be reached at

800-332-6273 experts@forensicDJS.com.

www.c la imsmag.com   Claims Magazine

  DECEMBER 2 6

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