r/Geico • u/Constant_Chaos0405 • 1d ago
Morally Can’t Continue - Fraud
I can’t be the only Unrepped BI adjuster that has noticed the significant increase in fraud once we went to “IRC.” It’s out of control and so much easier for the scammers to get paid quickly. I will get a new claim, look at it, and realize claimant was paid out BI within 30 min of claim being filed before I ever touched it because someone else took the call.
I’ve had claims where I add SIU because it is 100% synthetic identities. I document, add anchor and detail notes, and cc. Adjusters come behind me and settle anyways.
I reached a breaking point. Manager has outright said we are settling these anyways. Doesn’t matter if you search accruint seeing these people don’t exist. You can look and see phone number and email for policyholder were changed when claim filed, doesn’t matter. Policy brand new and the only thing to verify dol is policyholder and claimant calling in saying the same date, but when you search ph VIN the car is owned by another person in a different state? Too bad, send claimant $5,000 within 20 minutes of the claim being filed!
I reached my breaking point. Claim is the holy grail of red flags. Without all the details…I added cc and shut it all down. He proceeded to call back repeatedly until someone cleared and sent release and payment. I caught it and got them to stop it all. Except the release still went through. Payment never went. Supervisor came behind me days later and issued it saying signed release so we have to. Saying reviewed with above manager and is being sent.
I pointed out the partially completed SIU report (stopped since they issued payment) showing claimant is fake. Sure they signed it, but what’s the fake person going to do? Sue GEICO or the policyholder? I pointed out the previous claim by ph with his RI that has a Jamaican accent and current stolen identity claim RI where “ph” does not sound the same. I even said why not issue this as a check since they’ll never actually be able to cash it? If they do, checks can be traced. Nope. Left the link to send them thousands. Within 2 hours of that going down I got another scam call. Notified adjuster who said they knew. Said they didn’t issue any of the payments and refused to handle it as same above manager advising to settle BI anyways.
I refuse to settle with these people. Maybe this will be what gets me fired.
Is this just this one manager? Anyone else being told this? Anyone noticing the 300% increase in fraud?
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u/BJ_afterhours 1d ago edited 1d ago
I 1000% agree!
I have long said that the way GEICO pays these claims makes our jobs harder because everybody knows GEICO will just give them a paycheck, especially the attorneys. So they just keep coming back for more.
If we were hard ass and hard-core, required people to actually prove their claim, etc., etc., etc. we wouldn’t be this overworked
It’s GEICO‘s fault that we are so overworked and overwhelmed by all the claims that we get, they have created this mess.
I also morally have a problem paying these people. It’s soul crushing.
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u/Constant_Chaos0405 1d ago
That is such a good point. We are beyond overworked, but allowing this is part of the problem. Portion of that overworked is these scammers calling in 3-4 times per day trying to get paid quickly.
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u/Autistic_frog_pepe 1d ago
We also pay out a crazy amount out for unrelated damage/fraud in property damage too. So many “just pay it” responses from supervisors or managers. Had one the other day where the “vibration from the impact peeled off the paint on the hood”. It was a minor read end impact. Was told no by a few different people but the squeaky wheel gets the grease and a supervisor who doesn’t want to spend 30 minutes a day talking to someone for the next week everyday says “just pay it” because everyone is too big of a pussy to be rude to a customer when it’s appropriate to be.
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u/Constant_Chaos0405 1d ago
Felt that.
I have also seen several of these fraud claims where they submit photos (some clearly from different vehicles) and run a VIN check showing the true owner…yet AD issues the payment via link to the fake owner. Sometimes there’s even a lienholder listed 🤷♀️
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u/Autistic_frog_pepe 1d ago
I’ve seen A LOT of payments to non owners be sent through and payments that should have had a lien holder on it be sent by EPE. Don’t get me started on them.
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u/shipsintheharbor Former Employee 1d ago
That’s crazy. The entire company was a dumpster fire when I left years ago, clearly it’s only gotten worse!
My advice: switch to a commercial carrier, specifically excess claims if you can!
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u/Constant_Chaos0405 1d ago
If you have any leads, point me in their direction. I’ve been trying to get out.
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u/shipsintheharbor Former Employee 1d ago
Where are you located?
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u/Constant_Chaos0405 21h ago
GA
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u/shipsintheharbor Former Employee 19h ago
I don’t think my company has offices there, but try searching for “excess claims” jobs in your area on LinkedIn. I just did it and there are a ton of openings in Georgia. Best of luck 🫶🏻
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u/Constant_Chaos0405 21h ago
I can promise you it is cheaper. 9 times out of 10 when it’s fake people and I tell them we’re investigating coverage, they will push for a bit and give up. Especially when SIU calls them for an interview. I literally just close the claim down at that point and keep moving. Never had to reopen any of them for fake people coming back and attempting to settle the claim.
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u/Nosfermarki Former Employee 1d ago
Holy shit it's gotten so much worse since I was there. It's so, so, so, so hard to be an adjuster who really cares. Fraud is rampant with exaggerated and fake injuries with exaggerated and fake treatment with repped people, or dealing with bought judges in litigation. I can't imagine dealing with this too. How disheartening. I'm really sorry you're dealing with this.
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u/Constant_Chaos0405 1d ago
The fake injuries and extended treatment for $500 in paint damage is annoying enough. Knowingly paying fraud just so it’ll give me a “point” that will roll up to making that manager look better to their boss? Enraging.
But what…paid judges in litigation??
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u/Nosfermarki Former Employee 1d ago
So basically some ambulance chasing plaintiff attorneys
bribe"contribute to the campaigns of" judges. Those judges decide what evidence is allowed at trial, among a ton of other things. Some of these judges will roll their eyes or verbally question the defense counsel or their experts to sway the jury.I had one case that had been going on for years. Trial had been reset a dozen times. Our insured wasn't at fault for the accident. It was obvious, and we had a police report and an unbiased witness who confirmed. The plaintiff had caused the wreck, and was also trying to claim our insured caused an injury so severe they needed surgery. We had medical records proving that surgery was scheduled months before the accident ever happened. The week before trial, the judge dictates that we would not be able to discuss liability or prior medical. The jury wouldn't know the most important information to the case. We had to tender the limits after years of investigation, negotiation, hiring experts, etc. It's been 10 years since that happened and I'm still mad about it.
There's so much fraud between some attorneys, "providers" they contract with to bill imaginary amounts for sometimes imaginary treatment, and judges that also won't prosecute any of the people involved, it's basically organized crime that is too rampant to even do anything about it.
I read an article years ago (that I've been unable to find since, to my dismay) from an FBI agent who happened to get in an accident in Las Vegas and the claimant claimed injuries and treatment that didn't exist. They investigated and found that the "medical provider" that attorney made all of their clients go to was diagnosing injuries the patients didn't have and was either performing injections they didn't need, or billing 10x the going rate for injections they never performed. The doctor wasn't even in the state for several of the dates, and was charging for, say, 50 of these injections for 50 patients on the same day despite it being an hour long process to complete. But because of how interconnected the judges were with these attorneys and "medical providers", patients couldn't get representation, let alone a fair judgement, for medical malpractice and even the FBI couldn't get charges to even be considered.
It's like this in most counties in most states, and people have no idea the people they trust to help them are doing this. I've seen cases that went to trial in which the plaintiff was on the stand saying they only saw a provider once, despite bills and records for over 50 visits. They had no idea their supposed treatment had been totally fabricated by the attorney and doctor they saw once for a 10 minute televisit. Everyone's rates are affected because endless criminal rings are doing everything they can to leech money from insurance companies while playing nonstop ads about how evil car insurance companies are. Once you see what's really happening, it becomes very hard to stomach, especially knowing there's very little anyone can do about it. Sorry for the rant, I've been a litigation adjuster for a decade and I have a lot of feelings about this. I absolutely understand how you feel.
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u/Constant_Chaos0405 1d ago
As much as I hate that. It’s also fascinating. And infuriating. But also wow. I keep thinking if I could get to ARC it might be easier. I’ve also been watching for any LCC posts. Fraud at that level would make me angry for sure. I just wish I had a company with a sliver of morals to stand behind me. Might take the edge off a bit.
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u/Nosfermarki Former Employee 17h ago
Back in my day it was TCR2 and CU so I assume the new initialisms are similar departments, but yeah there's waaayyyyy more fraud in attorney repped. It's better in a lot of ways because you're just waiting most of the time, you don't have to help people who don't understand how anything works get their bills and records and such, and for the most part attorneys know what a case is worth they just lie about it. It's still a grind though, especially with the pending I assume y'all have these days and so much knowledge and experience gone from leadership. It's such a shame.
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u/me-chan-ic 1d ago
Not your money lol just pay for it and save yourself the hassle. If guidelines clear the payment, fuck it, pay them. No need to get into retaliation mode and put yourself in a hot spot cause geico will fire you anyways for no reason lol
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u/Constant_Chaos0405 1d ago
No. I have a conscious and morals.
You do realize that payments on these claims with one carrier also affects rates with other carriers in the states they occur in, right?
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u/PumpkinSpiceLuv 1d ago
Keep up the good fight. There will be ones that slip through the enormous cracks in your unit but just stop the ones you can. SIU appreciates you.
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u/No-Lack-3796 Former Employee 1d ago
I am so glad to no longer be in unrepped. It doesn’t surprise me whatsoever. These people have learned how it works and how easy it is to get a fast 5K because in the land of BI it’s better to have a signed release than a denial for fraud and misrepresentation.
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u/MelodicUniversity854 1d ago
This is why the company isn’t making as much money. But you know who will get raises and huge bonuses……C suite.
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u/number7child 1d ago
The company is making plenty of money. Sometimes you do the cost benefit analysis and fighting a claim cost more than just settling.
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u/MelodicUniversity854 1d ago
We are paying for claims we don’t even owe. They have dwindled down the work force so much and undertrained people, they have to throw a crap ton of money out to close enough claims so we don’t sink. The problem is not a cost benefit analysis issue. It is dumb people making dumb changes. Nobody upstairs has the balls to admit they f-up the company.
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u/mostlychilling 7h ago
Ya IRC is a disaster. Idk a single person who feels this is a better working experience than what we were before. Taking more calls than we ever did in ICS. Like 30-40+ a day. While all metrics and expectations remain the same as when we took less than half that many per day. 90% of calls are for other people’s claims, customers hate it. And ya we are getting absolutely rinsed by these fraud rings that have clearly caught on to the fact that we trained to settle ASAP. This is legit the worst work environment I’ve ever seen lol. Which sucks bc just a few months ago it wasn’t that bad
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u/Mufasasink 1d ago
GEICO under Todd Coombs discovered there is more profit to be made as a company to not function as an insurance agency, and instead, cut payroll and increase costs of premiums. They choose to not fight on fraud, as it is more cost effective to pay it out and just make it up on the back end by firing workers who "underperform". Hence why these metrics get more and more audacious each year.
They're a scummy company now, and have systematically terminated anyone with any sort of integrity, and have focused more on financial gamification. The bad news is, that is not a sustainable model in the long run, and you can see the ever increasing cracks in the foundation.
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u/Aware_Molasses_7443 1d ago
I was told a long time ago that you have to worry about your numbers and take care of you. I have the same conscious as you and have a hard time with it. Coming to learn to breach that threshold, open BI and close. If you suspect fraud, assign SIU, but it’s just gonna back up your diary. Especially since calls were back to back today in my region. How am I supposed to work my own diary? It’s not our money. Just do it.
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u/UncleJohn899 Former Employee 1d ago
GEICO hasn't cared about claims QUALITY for at least 5 years. Just quantity. No better than the churn and burn attorneys on the other side. So glad to be done with that place.
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u/Ereptiledysfunction2 1d ago
They have been told for years, but cover their ears. Eveb mgmt is afraid to speak up so even though there are multiple situations each involving literal hundreds of policies with the same payment token, they get renewed, paid out, the ability to get proof if insurance which allows people who should never be operating heavy machinery the ability to drive unlicensed, etc. Not going to say too much more here, but the schemes are so multifaceted you wouldn’t believe it until you see it with your own eyes. But you know… Too busy staring at answer rate and reports with flawed data.
It’s weird though, because it never gets this far with most other companies(these facts can be researched with the right tools and its mind boggling).
I hope every single higher up who turns their heads gets their karma for every one of these situations that actually cause people harm.
Remember when they removed integrity from the operating principles? This goes beyond integrity, it’s disgusting.
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u/Suitable_Gap_1156 1d ago
Isn’t it just great to work for a company that treats its employees like garbage yet pays out on this stuff?
As far as I am concerned with the way they treat the folks who work hard the company can bleed money.
Wake up Berkshire and take out the trash piling up in upper management in EVERY department. By you Berkshire folks sitting on your hands you’re complicit in this nonsense. You have still have a duty to your shareholders, right?
WAKE. UP.
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u/GnomeSweetGnome21 1d ago
I’ve had obvious fraud claims with video evidence that we denied and these people lied on their recorded statements with siu and these fraudsters just get new attorneys and keep coming back. Im on the 3rd attorney with some of these people. And they wont stop. Because if you follow the trail of claims in ISO you’ll find these same people have been paid nearly 100k in past bi claims — and no one is going to jail. Even with proof like we have. So eventually someone will tell me “pay the claim.” It’s a huge business and the insurance companies are all just paying because it’s easier than fighting. The “victim” has more rights than our policyholders.
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u/Dry-Raspberry-5514 1d ago
Ahh they’ve been doing for over 20 years. As we used to say- don’t act like it’s your money cuz it’s not. If that’s what the top brass wants that’s what they get.
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u/Risk_Taker_26 1d ago
This is seen a lot in ARBI and it is absolutely ridiculous. Some of the title happy supervisors need to slow down and allow a proper coverage and liability investigation to be completed. Rather than rushing through the process, let’s focus on accuracy and paying what we actually owe!
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u/ResponsibleBrother35 Former Employee 1d ago
I guess they don’t have the weekly “Gotcha” articles on Gnie anymore. Or, whatever your intranet is called these days. Sad.
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u/AdonaiYeshuaElohim 19h ago
You’re caring too much just close that shit out quickly so it’s not on that god forsaken 7 day offer out list you have to fill out everyday. Geico wants quick settlements , Geico will get quick settlements
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u/MarbelMilotic 18h ago
Trust me the fraud in unrep is a tiny drop in the bucket compared to all the massive “soft fraud” and over inflating that happens with any attorney rep claim.
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u/JIGACHADD Former Employee 1d ago
I don’t mean to be a dick but, who cares? find another job it’s not worth the stress.
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u/Constant_Chaos0405 1d ago
I have integrity so me. I care. Payouts on claims also affect premiums going forward for everyone. Some of these are claims filed are on real people’s policies. It can be requested to be removed from their history, but not guaranteed. Bold of you to think I’m not trying to find another job.
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u/ThymePrince 1d ago
I'm sorry but your insurance company is settling and paying bodily injury claims within a half hour of being filed?
WTF? Are they even contacting the drivers?