Moments like that were rare, but ironically the biggest one big one I ever did involved a piddly little Personal Injury Protection (PIP) claim with Nationwide Insurance that was worth less than $2,000. For some reason, they suspected fraud - still not sure why. It was a significant wreck, and both claimants were mentioned on the police report and reported injury at the scene. It didn't even smell fishy, but they wanted an examination under oath (EUO) - meaning to question my client under oath as in a deposition. I was somewhat new, so my boss still coached me quite a bit. He told me that it made little sense but that because it was a first party claim, we had a duty to cooperate and had to allow it. He also told me to let them have pretty broad latitude, because the last thing you want to do is get your client's claim ruined because you didn't cooperate.
So the fraud investigator and the adjuster came to my office to conduct the EUO of my client. The investigator did the questioning, and after a few minutes, he got a very aggressive tone for no obvious reason. He spent about 3 hours asking a bunch of background questions that had nothing to do with the claim and were clearly to exhaust my client (who was an old lady). A few times I considered fighting back or shutting it down, but in the back of my mind, I thought about what my boss had said about the duty to cooperate and didn't want to screw that up. Then he spent about 5 minutes on the actual claim. "Finally," I thought.
But then he said, "well I have run back to San Antonio for another appointment, but will you agree on the record to submit to another examination like this for further questioning next week?" That was the end of my patience.
"No, she will not."
"But I have more questions, and you have a duty"
"I know what our duties are, and you're free to question her more today if you want to, but we're not doing this a second time."
"But I have to get going."
"[With a bit more intensity.]I didn't tell you to waste three hours on pointless background questions that had nothing to do with the claim. You made that decision, and it was stupid one, but that isn't our problem. Now are you going to get to the relevant questions, or are we done now?"
"We're done, and off the record."
Then instead of just quietly ending these, the MFer (who was kind of a tall guy but clearly had small penis issues) pushed me harder off the record. "You should have agreed. I'm advising the carrier to deny this one."
"You have no basis for that, but you can do what you want and face the consequences of it. However, right now, I want all of you to get the hell out of my office, before I really get mad and hurt somebody."
Then I looked to the adjuster and said, "If this claim is not paid in full in 24 hours, Nationwide is getting sued, and every single one of you are getting sued, including this ******* [gestured to the fraud investigator]."
Then I turned to the investigator, "and if you think you're a tough guy for badgering an old lady, just wait until you're in the witness chair facing me. Bring your mom and some tissues, because you'll be in tears before I'm done with you. Now beat it." Looking intimidated, he left.
By 10:00 a.m. the next morning, the adjuster showed up at my office, personally apologized for the fraud investigator's behavior, and paid the claim. He denied involvement in the decision to bring him in - pinned it on his supervisor. I didn't believe him at first, but I had several other claims with him after that and was totally professional. Maybe he was telling the truth.
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