The IAATI Insurance Investigator of the Year Award
Nominations Deadline: May 01, 2020
This award was created in 2014 in order to recognize and honor insurance professional (individual or group) for his or her outstanding contribution in the area of vehicle theft investigation or insurance fraud investigation.
For information on the judging criteria for this award and tips on how to apply please download the 2020 IAATI Insurance Investigator Award_How to nominate brochure at https://www.iaati.org/awards/insurance2020
By Mark Pollard (President, Australasian Branch)
Steve Tully retired from the South Australia Police at the rank of Brevet Sergeant in the position of a Forensic Investigator and Vehicle Examiner in 2016 and began contracting to F.I.R.E.S. and Insurance agencies for Forensic Vehicle Examinations.
In June 2019, at the request of a local insurer, Steve Tully was appointed to examine a silver, 2007 Holden VE Berlina sedan that had been written off due to fire damage. It was reported that the owner had parked the vehicle in a private yard on Thursday afternoon prior to the fire. The insured stated she was going away overnight with her partner in his vehicle as it was bigger and could accommodate them and their young child. She stated she had left the vehicle locked and did not have any issues with the vehicle prior to this incident and that the vehicle was well maintained. At about 7.30 pm on the Friday night, she received a call from Police saying her vehicle was on fire.
As a result of the damage, the owner lodged a claim with her insurer, stating she was informed the fire was a result of an electrical issue inside the vehicle and due to the type of damage sustained to the vehicle, the vehicle was written off as non-repairable.
Steve Tully was contacted and appointed to examine the vehicle at the location where the incident took place. At the time of examination, the vehicle had been found behind a shipping container on a small unfenced business block of land in an industrial area of Mount Gambier (South Australia). The area was an industrial estate with several other companies.
The vehicle had sustained extensive fire damage to the entire passenger compartment which was totally consumed. Further examination established that the vehicle’s windows were fully down (open). Whilst the exterior of the vehicle had sustained fire related damage, the fire was only to the upper roof and top of the doors, and left front side. Both the bonnet and boot lid were in the closed position and did not show any signs of being forced open.
After Tully forced open the luggage compartment lid he noted the compartment had sustained some fire damage and that the main battery of the vehicle (which was located in the luggage compartment on these models) was still connected. For safety reasons, he disconnected the battery terminals. The plastic battery cover was melted over the top of the battery which was undamaged.
Tully then forced open the bonnet to examine the engine compartment. The engine compartment whilst burnt, the damage was relatively less compared to the interior of the vehicle. The fire damage consumed the left mounted air box and upper plastic and rubber components within the engine compartment. The right side of the engine which housed the electrical systems fuse/relay box was only slightly damaged with the fuse box lid melted over the housing. The fuse/relay box was complete under the melted top cover.
During Tully’s examination of the interior, a strong smell of an accelerant was detected. Samples were collected but did not reveal a source of the odor.
No personal items were located in the luggage compartment or within the burnt remains of the interior.
Tully then examined the engine and noted that with the little amount of fire-related damage, the engine would not rotate. Tully then sought permission from the insurer to investigate the engine issue further as the extent of fire damage to the engine compartment did not explain why it would not rotate.
After Tully received confirmation to proceed further with his examination he removed the cylinder heads. With the cylinder heads removed it was evident what the issue was. The timing chain had jumped a few teeth, causing the camshaft and crankshaft to be out of sequence, causing the valves to dig into the pistons. This caused the engine to seize. It would have been impossible for the insured to have driven the vehicle to its current location as stated as the engine would not turn over, let alone start.
Further investigation identified the insured had purchased a larger vehicle with her partner a few weeks prior to the fire as they had recently had a child. The damaged vehicle had been parked at the current location for weeks prior to the fire and had not just been driven there the night before.
As a result, the claim was denied and the insured is now a subject of insurance fraud investigation.
In recognition of Mr. Tully’s professionalism and thoroughness in the above investigation, he was selected as the winner of IAATI’s 2020 Insurance Investigator of the Year.
Congratulations, Mr. Tully! Well done!
Senior Investigator Daniel Burke (2nd from the left) being honored with the 2019
IAATI Insurance Investigator of the Year Award.
Below is a copy of the Nomination submitted for Daniel Burke:
As an International Underwriting Agency, our board takes great pleasure in having the opportunity to nominate Senior Investigator Daniel Burke in the category of ‘Insurance Investigator of the Year’. Our nomination is in appreciation of Daniel’s expert and comprehensive investigative techniques, which resulted in the recovery of insured excavators, including attachments (insured value $AUD180,550.00) stolen within Australia. Furthermore, Daniel’s investigation detected additional criminal offences linked to the theft of insured excavators including multiple burglaries, with the investigation linking a senior Claimant employee (Branch Manager) as a co-conspirator in an organised property crime syndicate.
This nomination acknowledges Daniel’s skills in dealing with both internal and external stakeholders relevant to the claim, while demonstrating the very highest level of professional expertise; this allowed for the identification of offenders, location and recovery of excavators and detection of risk management deficiencies within the Claimant business. Daniel was able to produce a comprehensive factual Brief of Evidence, which would enable police to successfully acquire a Court-issued Search Warrant, locate and seize stolen excavators and deliver criminal charges against correctly identified offenders – all of whom were linked to multiple criminal offences. During the investigation, Daniel strategically planned, led and coordinated a multifaceted operation, which involved numerous stakeholders. Throughout the investigation, Daniel concisely communicated with senior commercial and government sector professionals to ensure the investigation achieved the most effective outcome.
On Friday 20 July 2018, the insured suffered a burglary at their secure compound, which resulted in the theft of multiple excavators and attachments with an insurable gross value totalling $AUD180,550.00. The theft allegedly occurred a short time after 6:30pm, directly after the Branch Manager had locked the front gates and departed the area. On Saturday, 21 July 2018, the Branch Manager allegedly attempted remote login to CCTV cameras for a random security check, at which time he identified the CCTV cameras were disabled. The Claimant compound was closed and unmanned over the weekend period which served as the reason why the Branch Manager performed a random security check via CCTV cameras.
The Branch Manager subsequently instructed a junior supervisor to attend the compound and conduct a physical inspection. Shortly after, the junior supervisor reported that the compound had been burglarised by way of forced entry, with the perimeter security fencing and site power supply having been cut; he also identified that a number of excavators and their attachments had been stolen. The Branch Manager immediately notified Head Office before attending the compound, and subsequently reported the incident to police. On 23 July 2018, a claim for the theft of excavators was lodged with insurers via the Claimant’s Insurance Broker.
Due to the quantum of excavators stolen, along with a review of the risk, we appointed Daniel to undertake a full investigation in order to factually confirm the circumstances surrounding the loss.
At the investigation’s onset, Daniel undertook a comprehensive review of the insured’s policy and claims history along with criminal activity in surrounding suburbs. This was undertaken to establish fraud indicators, disclosure issues and the prevalence of similar offences or active offenders targeting the area. Thereafter, Daniel undertook physical inspection of the theft site which established entry and exit points, aspects of CCTV camera operation and site security measures (along with establishing potential witnesses); amongst other prominent evidentiary findings, this resulted in cultivation of what would become a key witness at a neighbouring business.
Initial enquiries were conducted as follows:
Site of loss inspection – identified a defined modus operandi (‘inside-job’) confirming offenders had knowledge of CCTV camera operation including how to disable the system without being detected.
Review of GPS data – GPS devices were fitted to the stolen machines, however they were quickly located by the offenders, removed and left abandoned on the ground at the Claimant compound – Daniel requested all GPS data for the incident date be retrieved for his review, with this process yielding pertinent evidentiary results.
Witnesses – canvassed neighbouring businesses, successfully identifying a witness who stated his business had been subject to a burglary on the evening of Sunday 22 July 2018, whereby the only property stolen was the CCTV camera hard drive. It was established that the CCTV camera at the neighbouring business directly faced the site of forced entry at the Claimant’s compound. It was also established the Branch Manager from the claimant business had made a phone call to the business owner enquiring about any possible CCTV footage on Saturday, 21 July 2018. At this time, the Claimant’s Branch Manager was informed that CCTV footage would be available on the morning of Monday, 23 July 2018 when the office was reopened, whereby the CCTV hard drive could be accessed.
Background checks – extensive background checks were undertaken on all employees working at the Claimant’s compound. This included briefings with the CEO of the Claimant business and close review of personnel files.
Operation Action Planning – Daniel identified key persons of interest, potential motives and linked offences occurring in the immediate area. He further compiled and disseminated a detailed ‘Op Order’ including specific investigative steps and resources required for a successful investigative outcome.
Key Stakeholder Communication
The Claimant business is a large-scale national company, which operates by way of hiring or leasing mobile plant and
machinery through numerous locations spread across Australia, therefore the management structure is layered and
comprehensive. We were extremely impressed at Daniel’s ability to leverage the Claimant’s Broker to facilitate meetings with the CEO, and subsequently negotiate a full management ‘buy-in’ for the investigative action required. Daniel’s communication during this process was critical and expertly executed; he exhibited a tempered and precise manner while presenting his investigative plan which would target senior employees at the Claimant business – who were, at the time, believed to be ‘above suspicion’. Daniel was able to successfully broker this outcome by concisely presenting his preliminary evidence in a professional, confident and resolute manner while at the same time delivering expert and insightful advice on criminal behaviour including modus operandi pertinent to ‘inside jobs’.
Daniel instructed the Claimant CEO to covertly supply all mobile phone records for senior employees working at the
compound. The phone records were closely examined, and a number of ‘suspect’ phone calls were identified requiring further enquiries. These ‘suspect’ calls included the Branch Manager making several phone calls to a cell phone, while the Branch Manager was located within the cellular tower suburb of the Claimant compound on the evening of Sunday, 22 July 2018 between 6pm and 7:30pm. The phone records further identified that the Branch Manager had called the owner of a neighbouring business on Saturday, 21 July at 12:00pm (reported) and then again on the evening of Sunday, 22 July 2018 at 7:00pm (not reported), with this particular phone call being made from within the cellular tower location of the Claimant’s compound. Daniel’s earlier enquiries confirmed the same neighbouring business was burglarised on the evening of Sunday 22 July 2018, with the only property stolen being the aforementioned CCTV hard drive.
GPS tracking devices
While the excavator GPS tracking devices were disabled and discarded within the compound, Daniel requested all GPS data from the devices for the period leading up to their deactivation. Daniel’s detailed review of the data confirmed GPS information had been recorded when the machines were started (ignition on) at 6:24pm on Friday, 20 July 2018, prior to being disabled. This key piece of evidence allowed Daniel to establish the precise time of theft which contradicted the Branch Manager’s version, in that, he had secured and departed the compound at 6:30pm.
Daniel established that the offenders entered the site by way of cutting through security fencing at the top of the secure
compound, before making their way to a site power box where they disabled all compound power (including the CCTV
cameras). The offenders then progressed on foot through the compound before arriving at two excavators parked at the front gates of the compound. The offenders started the excavators and located the hidden GPS devices, before disabling and discarding them. The offenders then used bolt cutters to sever a padlocked chain securing the front gates, after which time they removed the excavators from the compound by way of tilt tray trucks, which were positioned in wait at the front gate entrance.
The incident re-enactment conducted by Daniel established it would take offenders (with no knowledge of the compound and GPS device location) at least six minutes to arrive at the excavators and disable the GPS trackers. It was noted that the Branch Manager had reportedly left the compound at 6:30pm, and Daniel’s review of phone records confirmed he made a phone call which bounced off the local cellular tower at 6:33pm.
The re-enactment confirmed the offenders entered the compound at around 6:18pm (or earlier) before starting (GPS tracker – ‘ignition on’) the excavators at 6:24pm. The Branch Manager’s initial version of events and phone call records placed him at the compound up until 6:30pm, indicating he was present when offenders entered and manoeuvred through the compound.
Interview – Branch Manager
Daniel’s preliminary investigation determined the burglary and subsequent theft of insured excavators was likely the result of an ‘inside job’ and further the burglary of the neighbouring business was a linked offence committed by the same offenders in order to eradicate CCTV footage.
As a result, Daniel centred initial investigations around the activities of the Branch Manager before, during and after both burglary events. It should be noted, the Claimant CEO had initially advised Daniel the Branch Manager was well paid, earning $170,000 per annum, and was a trusted and hardworking employee. We were impressed at how Daniel remained resolute in pursuing the Branch Manager based on his skilled interpretation of evidence gathered.
The key outcome of the electronically recorded interview, which included an interview phase followed by non-confrontational interrogation, was that it locked the Branch Manager to a version which was inconsistent with background facts established during Daniel’s preliminary investigation. The Branch Manager was subsequently caught in a number of incriminating lies which further implicated him in the staged burglary and theft of Claimant excavators along with the subsequent burglary of a neighbouring business in order to steal and destroy CCTV evidence. During the two-hour recorded interview, no formal admissions were made, however an acknowledgment was made by the Branch Manager insofar as the body of evidence implicating him in the offence. More importantly, Daniel elicited very prominent information, which subsequently identified a second person of interest and opened the investigation to further key lines of enquiry.
During initial telco enquiries, it was established that a ‘suspect’ cell-phone number was contacted a number of times by the Branch Manager in and around the time the neighbouring business was burglarised on the evening of 22 July 2018. Daniel subsequently placed this cell phone number through database enquiries, which linked the number to a residential address, however this failed to identify a name. Daniel briefed the Claimant CEO of developments and provided him the ‘suspect’ cell number, requesting that internal databases at the Claimant business be checked for a match; these checks revealed the cell phone number belonged to a customer who dealt exclusively with the Branch Manager at the centre of Daniel’s investigation.
Daniel placed the customer’s name through open source intelligence gathering systems, which revealed an extensive criminal history, including a recent six year period of incarceration for serious violence and property related crimes.
At this point, Daniel utilised industry-leading, desktop aerial imaging technology to facilitate visual inspection of the address linked to this person of interest. These aerial images revealed a number of excavators positioned behind security fencing at the suspect address. Further, open online checks into the person of interest’s credit history and property ownership encumbrances, revealed no obvious financial means to facilitate acquisition of such property.
Daniel subsequently instructed a surveillance operative to attend the suspect address and conduct a spot inspection to identify the type of excavators which were stored behind the security fencing. This resulted in physical identification of excavators, which directly resembled those stolen from the Claimant business, however no positive identification could take place due to the excavators being locked and secured within private property surrounded by 6-foot security enclosed fencing.
Daniel immediately actioned and controlled a private surveillance operation while he communicated with specialist police detectives. The surveillance operation spanned a two-week period, and its coordination was complex due to the geographical location of the residence which was positioned adjacent a busy Islamic Mosque. The surveillance operation successfully identified additional excavators, numerous persons of interest along with vehicle registrations frequenting the suspect address.
During this period, Daniel was able to supply police with a comprehensive Brief of Evidence, which enabled their acquisition of a Court-issued Search Warrant. Daniel’s comprehensive Brief of Evidence also linked the offenders to similar offences committed within the immediate area, with this information having been sourced through published police statistics and other known insurance claims.
Location of Offenders & Excavators
Police executed a Court-issued Search Warrant, which resulted in location of the Claimants property. It also resulted in the nominated suspects being taken into police custody subject to multiple offences. The Claimant business was able to end employment with their Branch Manager who was also taken into police custody as a person of interest.
Police initially seized the Claimant’s property for evidentiary purposes before Daniel coordinated return to insurers. This
investigation identified the perpetrators of an insurable loss with a gross insurable value of $180,550.00, including the police seizure of other high value property and machines. Of further significant importance is that the investigation detected a senior manager at the Claimant business who presented as a serious ongoing risk to the Claimant business and insurers.
Third Party Admissions & Liability
The Claimant CEO and Insurance Brokerage personally acknowledged the exceptional work and commitment undertaken by Daniel. They were extremely grateful and noted the professionalism of the investigation conducted by Daniel, and further were shocked that a senior manager had been linked to a serious crime committed against the business (whereby he was previously identified as being “above suspicion”). The Claimant CEO acknowledged the involvement of an employee and accepted his company had potential liability in the loss event.
This investigation was executed by Daniel using expert investigative techniques, planning and impeccable attention to detail. The Insurance Brokerage, the claimant CEO and Police gave Daniel’s investigation the highest praise. All aspects of the investigation were undertaken in compliance with the Policy of Insurance, Insurance Contract Act and the Supplier Agreement subject to external contractors. At all times, we were incredibly impressed at how Daniel expertly briefed all stakeholders while leveraging these entities to provide resources beneficial to the investigation.
Having seen hundreds of insurance investigations, we respectfully consider that Daniel’s investigation demonstrated the
highest level of specialised expertise in strategically executing a timely yet complex investigation, which required detailed planning, intelligence acquisition, coordination of various stakeholders and precise implementation. Daniel’s ability to manage all facets of this investigation including forensic examination, recorded interviews, witness cultivation, scene examination, telco tactics, surveillance coordination and police intervention ensured a highly successful outcome. We feel Daniel should be applauded for his diligent and unwavering pursuit of evidence through impeccable planning, demonstrated investigative skills, tenacity and precision of operational execution.
It should be emphasised that Daniel’s investigation not only achieved an exceptional result for UAA and its security QBE, but it also assisted the Claimant’s business in identifying a senior-level employee who presented as a serious ongoing threat to the Claimant business and Insurers if left undetected. In this regard, Daniel’s efforts showcased the ability to ‘value add’ by supporting and assisting Claimants in identifying and removing serious internal risks. Furthermore, Daniel was able to link additional machinery thefts to the suspects which are now the subject of ongoing police investigations.
The key outcomes from Daniel’s investigation include:
Modius operandi correctly identified as an ‘inside job’;
Linked criminal offenders correctly identified;
Location of stolen property correctly identified;
Full Brief of Evidence supplied to Police enabling acquisition of a Court-issued Search Warrant with sufficiency of evidence to pursue the offenders;
Offenders taken into Police custody subject to multiple burglaries along with theft of the Claimant’s excavators and attachments, gross insurable value $180,550.00 AUD;
Offenders linked to other similar offences which are not subject to ongoing police investigations;
Senior Manager responsible for managing millions of dollars’ worth of machinery, linked to multiple offences;
Internal risk deficiencies identified within Claimant business subject to staff monitoring and compound security measures; and
Excellent feedback from insurance Broker and Claimant business ensuring long term retention of a lucrative client.
It is our view that this investigation demonstrated a tremendous level of incisive investigative skills, with Daniel delivering all stakeholders clever authoritative knowledge on property-related crime methodologies, coupled with an ability to logistically plan and tactfully execute a complex, multifaceted operation, while ensuring a seamless and successful outcome for Insurers, Brokers, Claimant and police and further maintaining a high level of integrity, ethics and confidentiality with all parties involved.
We believe Daniel was responsible for engineering and delivering an exceptional insurance investigation. We consider this investigation demonstrates leading edge investigative techniques and is extremely deserving of our nomination for this award. We unreservedly endorse Daniel for all insurance investigations which require sheer tenacity, ingenuity and professionalism.
We believe that Daniel’s investigation offers confidence and positive reassurance to the wider insurance industry of the
inherent value in engaging auto theft investigators to undertake these types of investigations on behalf of insurers.
Regional Claims Manager,
Underwriting Agencies of Australia
John Borland, ISACORP Ltd. (New Zealand) receiving the Insurance Investigator of the Year Award from President JD Hough and committee chair, Mark Pollard.
This nomination was submitted by: Kristine Tempest, National Claims Manager Property & Marine, Commercial Claims, QBE Insurance, New Zealand.
Award Nomination – Senior Investigator John Borland
I am delighted to nominate Senior Investigator John Borland of ISACORP in the category of ‘Insurance Investigator of the Year’. This nomination is in recognition of professional and extensive investigative actions completed by John which successfully recovered three motor vehicles (valuing $291,200NZD) stolen in New Zealand and further identified parties culpable for the theft.
The nomination recognizes the ability of John in networking and fostering relationships with all interested parties and organizations associated with the claim which resulted in full recovery of the vehicles, identifying risk issues for the insured to prevent future loss, establishing third party liability of parties responsible for the theft and completing a comprehensive brief of evidence which provided evidence for the police to progress criminal proceedings against culprits. This nomination reflects John’s ability to plan and facilitate a detailed investigative operation, utilize innovative strategies and communicate on multi-levels with various professionals to ensure the investigation was successful.
On 26 July 2017, the claimant reported the alleged theft of the above mentioned vehicles from their secured compound located in the Auckland region. The claimant stated the three vehicles had been stolen on an unknown date between 1 March 2017 and 14 July 2017, the theft was identified only once a request was made for the vehicles to be distributed to another car dealership. Upon reviewing their fleet and job cards, the claimant confirmed the theft of the three vehicles, subsequently contacting the police and insurer notifying them of the theft. On 28 July, upon review of risk, I suggested to my claims handler to appoint John to conduct a full investigation in relation to this matter.
During preliminary enquiries, John completed a full review of the claimant policy and insurance history ensuring that our client had no fraud or risk indicators. His efforts were then immediately drawn to ascertaining points of entry for the theft, CCTV avenues and scene examinations. I recall being impressed by his urgency with regards to establishing critical CCTV before it was lost due to time lapse. John’s initial enquiries included the following:
- Scene examination – establishing possible points of entry/exit due to poor CCTV coverage.
- CCTV gathering – Identifying businesses in the area to obtain CCTV for suspect identification and direction of travel for stolen vehicles.
- Policy & History Review – Establishing claims legitimacy from the insured to negate fraud suspicion.
- Operation Order – Develop an operation order and action plan for the overall investigation
Initial Record of Interview
Given the profile of the claimant, I was impressed with the professional yet resolute approach John undertook when interviewing the claimant and broker. John successfully completed a detailed record of interview with insured, confirming there was no fraud, inflation or suspicion on the claimant’s behalf. Furthermore, John’s interview established new points of contact within the insured company to further investigative and relevant persons to interview.
John was able to determine vital points of the insurance claim which were previously unknown which included; an approximate time of loss, security records for entry/exit points, company CCTV footage which could be reviewed and potential witnesses to the theft.
Contact with Police
Following on from the interview John personally attended the relevant police station and had a meeting with the investigating officer. John was able to efficiently communicate with the officer successfully gaining priority of the investigation – this is particularly impressive as often assistance from the Police is very limited due to their work schedule. A ‘cross-operation’ was agreed to and John provided the officer with all businesses and intersections which had CCTV which the police attended and seized. The police agreed to complete the investigations pertaining to the direction of travel of the vehicles whilst John focused on the internal aspects of the claimants company. I am aware they held briefings regularly throughout the investigation and to date I believe the overall investigation benefited from this rapport building by John.
After the interview with the claimant and the Police, John commenced the body of his investigative operation. I recall he held meetings with a number of staff from the claimants company, establishing their integrity before delegating roles for them to complete which would expedite the investigation. John drew his attention to the CCTV from the company which he and a staff member reviewed for many hours. Together they reviewed all CCTV which covered a month and a half period – John with the assistance of the staff member identified that the theft took part on 6 July 2017.
Specifically the full CCTV review established:
- The entry of two suspects who entered through the security gate at night behind a delivery truck.
- The fifteen (15) minute period they were on the claimant’s property
- Partial description of what they were wearing
- The exit point where only 2 vehicles (BMW’s) were stolen
Upon observing only two vehicles were stolen at this time a further review was conducted of the claimants logistic records which identified the third vehicle (RAV4) was not stolen and had been placed in the wrong spot by an employee – immediately reducing the claim amount by approximately $35,000.00NZD.
After the CCTV was finalized John completed an examination of the site of loss, it was here he established vital information which allowed suspects to be identified. John identified the hangar from which the two motor vehicles were stolen had no signs of forced entry and it was confirmed the particular hangar roller doors were locked prior to the theft. John was adamant that persons responsible had to have had swipe keys to access for the hangar and would have unlocked the garage doors internally.
John then completed witness interviews with all contractors and staff identified on CCTV around the time of loss. Whilst this did not yield any information relevant to the investigation it emphasized the depth John goes to in ensuring all investigative avenues are covered.
John then briefed the claimant and appropriate staff with the view of reviewing the relevant CCTV to try and identify the suspects depicted. Through the use of investigative briefings John identified that an item of clothing that was worn matched that of a contracting company that frequents the claimant’s compound. John reviewed their staffing portfolio and established three (3) staff were rostered on by that company, suspect interviews were conducted with two (2) who provided accurate alibis. The final employee appeared to evade contact from John and the company owner – which resulted in John establishing that entity as a suspect in this matter.
I am aware that upon identifying this suspect, John completed another briefing with the investigating officer from the New Zealand Police. John requested that the officer complete a ‘ping’ on the suspects’ mobile devices to establish if he was at the site of loss when the theft occurred. Due to privacy reasons the results were never provided by the Police however it was established that the strategy had been ‘successfully completed’.
Third Party Liability Admission
At the request of the claimant, John allowed him to engage with the contractor with respects to providing the information discovered as a result of Johns investigation for comment. The owner of the company immediately agreed that the overwhelming body of evidence supported the fact that the theft was as a result of one of his employees and stated his company was potentially liable for the loss.
Location of Outstanding Motor Vehicles
Shortly after the interview between the claimant and the third party, the outstanding motor vehicles were located parked on the side of the road with minimal damage in a district north of the site of loss. The Police forensically examined the vehicles before relinquishing them to the claimant resulting in a physical recovery and return of $256,200.00NZD worth of luxury motor vehicles.
As stated above, the claim was completed by John utilizing various strategies implemented with planning and precision. All skills and strategies implemented abided by the written instructions, scope of expertise, the Fair Insurance Code and in accordance with the service level agreement relevant to all agencies involved. Of satisfaction was that the preferable outcome was achieved within timeframes dictated by industry codes and regulations. John ensured all parties were briefed where appropriate and ensured transparency at every stage of the investigation.
This investigation demonstrates John’s expert level of skill and experience in planning and executing complex investigations. His timely application of skills and strategies including; physical interviews, forensic examinations, police cultivation, suspect identification, telco strategies and CCTV examination resulted in a very successful outcome.
John should be commended for his attention to detail, adhering to legislation, demonstration of investigative skills and overall planning and implementation. It should be noted that the outcome of John’s investigation yielded a very positive result for QBE New Zealand and its shareholders. The detailed results subsequent to John’s investigation include:
- Investigation completed and property returned within one month of instruction
- Full recovery of three motor vehicles totaling a value of approximately $291,200NZD
- Risk issues identified for claimant to prevent future loss
- Third-party liability grounds determined for remaining recovery avenues
- Comprehensive report and brief of evidence which police were able to utilize for any further criminal proceedings
- Positive relationships fostered between a lucrative client and QBE New Zealand
In May 2012 Investigator Tom Pruett of the North Carolina Department of Insurance, Criminal Investigations Division received a referral on an individual who had recently filed six insurance claims on the same all-terrain vehicle (ATV). NICB Special Agent Darrell “Rusty” Russell soon joined the investigation. Upon reviewing prior claims history of the involved subjects, a pattern of possible insurance fraud quickly emerged.
Investigators confirmed that damage claims had indeed been filed multiple times for the same ATV, even though one insurance company had, in fact, totaled the ATV. Ironically, the investigators learned that owner of the ATV and the owner of the repair facility were one in the same, and that owner just happened to retain the salvaged ATV. Upon recognizing the nexus to the repair facility, Investigators Pruett and Russell began to coordinate their efforts with Inspector Marc Epstein of the North Carolina Division of Motor Vehicles.
The ensuing investigation determined that the fraud scheme was more complex and involved a ring of individuals, spearheaded by the same individual who just happened to own the three repair facilities that were allegedly performing the repairs. The repair facilities were being operated from the same location. It was determined that the suspects were buying salvaged ATVs, then securing insurance policies and filing claims alleging that the ATVs were falsely damaged while off-roading. Initially investigators identified 21 insurance claims totaling $121,261.92, or an average of $5,774 per claim.
The thieves soon graduated from ATVs to custom-built motorcycles with an average of $14,000 per insurance claim. Interestingly, the ringleader was authorized by NHTSA and the NCDMV to manufacture custom motorcycles, and as such, had the ability to assign vehicle identification numbers and create Manufacture Statement of Origins. In the same manner, the ring would secure insurance policies on the motorcycles and then file claims alleging that the bikes were damaged. The thieves would often provide the MSOs as proof of ownership. This scheme netted the thieves $517,004.13 in insurance proceeds. This total did not include similar schemes involving antique cars, boats and campers.
During the next two years investigators requested, received and reviewed countless insurance files from multiple carriers. The investigation culminated with the arrests of 11 people in conjunction with 45 fraudulent insurance claims totalling $671,241.09. On September 9, 2015, ringleader Spencer Bowman plead guilty to 12 different criminal counts. Criminal charges against eight other individuals await final disposition in the court system. Charges against the remaining two persons were ultimately dismissed.
The winners of the 2015 Investigator of the Year Award were a group of individuals who cooperated and worked tirelessly to bring to a successful conclusion, an investigation that lasted 2 years. It involved a network of people who, while living in New York City, had registered their vehicles in Massachusetts for the purposes of a lower insurance rate. After an initial investigation, the Insurance Fraud Bureau of Massachusetts was joined by the Northwestern District Attorney’s Office, who in turn solicited the assistance of the Massachusetts State Police, Department of Homeland Security and the New York City Police Department. As the result of this multi-agency collaboration, a total of 48 individuals were charged with over 300 counts of insurance fraud, perjury and conspiracy. This success was a direct result of the professionalism and dedication of the Task Force members who were collectively the winners of this year’s Insurance Investigator of the Year Award:
- First Assistant District Attorney Steven E. Gagne, Northwestern District Attorney’s Office, Northampton, Massachusetts
- Michael C. Cantwell, Lead Investigator, Western Mass Task Force, Insurance Fraud Bureau of Massachusetts (Case Investigator)
- Matthew F. Markiewicz, Senior Investigator, Western Mass Task Force, Insurance Fraud Bureau of Massachusetts (Case Investigator)
- Mark E. Hannigan, Senior Investigator, Brockton Task Force, Insurance Fraud Bureau of Massachusetts
- Gregory M. Materas, Investigator, Insurance Fraud Bureau of Massachusetts
- Lieutenant John Cummings, Massachusetts State Police
- Trooper Corey Mackey, Massachusetts State Police
- Sergeant Kevin Crimmins, New York Police Department, New York City, New York
- Detective Patrick Donohue, New York Police Department, New York City, New York