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 [email protected].
www.c la imsmag.com Claims Magazine
DECEMBER 2 6
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