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STREET WISE Alliance of Insurance Agents of NC “What You Don’t Know Can’t Help You!” … Eddie K. Emmett, Editor / Publisher
Insurance Fraud Horror Stories Zalma’s Insurance Fraud Letter http://www.zalma.com/ZIFL-CURRENT.htm
My SUV just needed more money A driver thudded into Michele Mogel’s SUV, damaging the driver’s side. The Reading, Pa.-area woman received a $1,832 insurance check. She then filed 3 phony claims, saying her SUV was damaged by hit-and-runs. Mogel’s insurer paid her more than $3,800 for 2 claims. Another insurer handled her 3rd demand. The claim was identical to her original wreck, the insurer discovered in denying her $1,560 request. Mogel was convicted of all 3 claims. “I’ll lose my job. I can’t do that, I’m sorry.” she told Judge Thomas Parisi in refusing conviction. Mogel should be acquitted and paid simply because she has insurance, she asserted. “[My SUV] just needed more money. I wasn’t going to settle and let it go,” she said at her sentencing. Replied Parisi: “Quite frankly, I think you’re delusional at this point in time.” Mogel received a very real 1-2 weeks in county jail, plus 5 years of probation.
Rent to Own?
INSIDE THIS EDITION ¡Mucho Dinero, por favor!..............................
2
An offer you should refuse…………………….. 2 Water ya’ going to do now?............................ 4 Agent Guilty of Defrauding Clients…………… 8 They may wish they never made this trip……. 10
Denise Ramos said high-end possessions were burgled from her Las Vegas apartment. Farmers Insurance paid her more than $35,000. In fact she never lived there, nor was the apartment ransacked. Ramos also never owned many of the claimed items. She was an assistant manager at the apartment complex instead of a resident. She pleaded guilty. Ramos will spend up to 4 years in state prison when sentenced Jan. 11. Continued on page 2
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Insurance Fraud Horror Stories
Tell me where it hurts
Continued from page 1
¡Mucho Dinero, por favor! The 90-day sentence needs no interpretation. Philip Ward and his wife Kitzia Huerta-Ward ran an interpreter service called Hispanic Voices in the Seattle region. They fraudulently overbilled the state department of Labor & Industries for translating for injured workerscomp claimants at medical and vocational appointments. The couple billed L&I more than $16,300. They padded bills for legit interpreting, and charged for uncertified interpreters who used provider numbers of certified interpreters. The Wards also had interpreters leave part of their billing forms blank. They’ll finish up the forms, the Wards told interpreters. Except that L&I requires interpreters to complete the entire form. The Wards’ firm grew to 60 interpreters serving clients in 4 Seattle-area counties. The pair closed up shop in 2011. L&I’s investigation led to 90-day prison sentences for husband and wife.
Chiro rubs claim the wrong way Stand ground and fight the charges, or fold and cut a deal? Utah chiro Jace Ferguson had to decide, and fast. He’d treated 2 women injured in the same traffic accident. One patient noticed his Allstate billings differed from treatments she received. His jury trial began, and prosecutors carefully lined up each billed treatment with its claimed date. Prosecutors then quietly urged Ferguson to make a deal. He pleaded no contest to fraud on the spot— avoiding being strafed again before the jury. Several charges were dismissed in return, and the fraud felonies were reduced to Class A misdemeanors with no jail time. Ferguson also keeps his license, thus escaping with his life and career somewhat intact.
Addicts and drug dealers lined up for pills from pain doc Moshe Mirlashvili’s sham clinic. He wrote more than 10,000 scripts totaling nearly 1 million oxycodone pills. The Great Neck, N.Y. doc typically charged $200 to $300 in cash for “patient visits” that involved brief or no exams. Mirlashvili prescribed them large quantities of oxycodone. Few “patients” had a medical need for the pills. Mirlashvili forged documents such as cut-and-paste MRIs and urinalysis reports for varied patients. Most patients were members of crews— recruited and paid by drug dealers who were crew chiefs. The scripts were filled at pharmacies, and the pills were resold on the streets. Mirlashvili received a prescription for 160 months in federal prison.
An offer you should refuse Reputed mobster Ron Galati’s auto-repair ring cracked wider when an insurance appraiser pleaded no contest to aiding the large scheme. Cheryl Stanton was an appraiser for Erie Insurance, whose analytics help expose the ring and Stanton’s role. Galati bribed her cash and gifts to inflate claims involving his Philly body shop American Collision & Auto Center. Stanton also inflated claims for another body-shop ring. University Collision used a forklift to create scrapes, dents and tears to inflate insurance claims. Stanton signed off on many of the claims. An undercover detective posing as a customer agreed to an inflated repair bill of $4,600. University allegedly kicked back $200 to the investigator, calling it a refund. A corrupt Philly police officer also pocketed 20-percent cash kickbacks for each customer he referred. And he filed false damage claims for his own cars. Stanton received 7 years of probation for each case, and will be sentenced for 29 other fraud counts Dec. 2. Continued on page 4
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Insurance Fraud Horror Stories Continued from page 2
Crashing for Dollars Body-shop owner David Forlizzi bribed witnesses to give doctored testimony to duck charges of intentionally damaging vehicles for insurance payouts. Forlizzi and Fred Battista ran Collision Headquarters in the Boston area. The vehicles were damaged in crashes, vandalism or hit-and-runs, they told insurers. The pair bribed several cronies to help stage the crashes with their cars. Battista and Forlizzi finally were busted, and cronies fingered them as the masterminds. Yet the witnesses flipped at trial. They launched the plots themselves, they suddenly said. Battista and Forlizzi escaped conviction — they bribed Laura Battista thousands of dollars to lie on the stand. They also bribed Janet Vaccari to convince Deana Pistone to bolt the state and avoid testifying. And investigators found a text message urging: “Tell Laura to stick to her story.” Plymouth Rock Assurance referred the plot to the Massachusetts fraud bureau, and the case took off from there. Forlizzi and Battista received up to 4 years in prison. Vaccari, Pistone and Laura Battista pleaded and will be sentenced in October.
Water ya’ going to do now? A water pipe broke in agent Philip J. Snider’s new home, causing extensive damage. The Kennewick, Wash. man went to his office that evening. He’d listed his wife as the sole occupant on the homeowner policy. Snider secretly added himself to the policy.
AIANC’s STREET WISE
He also added $33,500 in building-code coverage, and lowered the deductible from $5,000 to $500. Snider filed a $37,000 claim the next day. Allstate’s anti-fraud analytics caught discrepancies. Snider was fired, and the Washington insurance department investigated. He received 80 hours of community service
Arson in Australia Insisting robbers tied him up and set his store ablaze, Adeel Khan says he’ll appeal his conviction for screwing up an insurance arson that killed a mother, her 11month-old baby and their neighbor in Sydney, Australia. Khan wanted insurance money, and to escape lease payments. He rigged 10 gas containers throughout his store. They all were connected by gas-soaked wicks. The fire quickly spread into apartment units above his store. Killed were Bianka and 11-month-old Jude O’Brien, and neighbor Chris Noble. Two others were burned. Security footage caught Khan filling containers with 38 liters of gas at a service station 2 days before the blaze. Robbers held him hostage in a storage room for 5 hours, he said. Yet investigators never saw the robbers on his security footage. A prison will hold Khan hostage for 40 years.
Adjuster + Contractor = $$$$$ A federal jury awarded Chubb $12.3 million after its own adjuster colluded with a contractor to inflate repair estimates and steer work after fires wrecked luxury homes in suburban New York and Connecticut. Dennis Sorge was a 30-year Chubb employee.
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October 2016
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Insurance Fraud Horror Stories
Three Years in Prison for Arkansas Woman Involved in Staged Accident
Continued from page 4
Chemer Beene, 35, a Little Rock, Arkansas, woman, was sentenced to a three-year prison term after being convicted of felony insurance fraud in a case involving a reported car accident involving a U-Haul rental vehicle. The Arkansas Insurance Department (AID) reported that Beene was sentenced in Pulaski County Circuit Court for her participation in a2015 scheme to collect insurance payouts from Repwest Insurance Co. from a purported vehicle crash. Damage-restoration specialist Paul H. Mertz Jr. was hired to independently assess hundreds of property claims for Chubb. The insurer contended that Sorge introduced Mertz to homeowners shortly after fires and improperly recommended him as an experienced, highend builder. Mertz improperly solicited repair jobs while working for Chubb. Some work wasn’t insured, and some repairs weren’t done. Chubb claimed Mertz submitted estimates that inflated work’s value, and quoted for high-end materials but used cheaper substitutes. Nor did he complete work for which he was paid, and also charged sales tax on items that weren’t taxable. Mertz repeatedly submitted estimates for extra work after he got the jobs, the lawsuit says. Sorge approved payments and failed to disclose the conflicts to Chubb. Mertz pocketed millions of dollars and shared payments with Sorge.
AIANC’s STREET WISE
According to AID, on September 30, 2015, Schanise Allen, 37, of Little Rock rented a U-Haul vehicle, purchasing the “Safe Move” insurance plan offered through Repwest. Later that same day, Allen reported that she rear-ended a Dodge Challenger driven by Johnathan Summons, 32, of Little Rock on Scott Hamilton Drive in Little Rock. Beene was a passenger in the vehicle driven by Summons, the AID reported. She was joined in the vehicle by Marquis Jones, 20, of Little Rock and Hilary Johnson, 19, of Little Rock. All five individuals made medical claims against Repwest from the reported accident with Summons also submitting a claim for damage to the rear left bumper of his vehicle.
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More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com Facebook friends with Allen. Warrants for felony insurance fraud were issued against all five individuals. Jones was arrested on Sept. 17, 2016, in England and is awaiting trial in Pulaski County Circuit Court. Summons is being detained on an unrelated charge and is awaiting trial. Allen and Johnson remain atlarge.
Guilty of Murder for Insurance Russell Bertram, 64, was found guilty of killing 26-year-old Leonila Stickney in 2009 by a Gregory County, South Dakota, jury on Sept. 26 that found the former South Dakota police chief guilty of first degree murder in the death of his pregnant fiancée in 2009. Prosecutors accused Bertram of killing Stickney to collect more than $900,000 insurance money. They also said jealousy was a factor because Bertram had undergone a vasectomy and knew the child couldn’t be his. Bertram, who had served as police chief in Harrisburg, South Dakota, was not charged until late last year. The victim’s estranged husband, David Stickney, received a letter after her death from a life insurance company that was processing a claim from Bertram. He then contacted the South Dakota attorney general’s office criminal division, setting in motion an investigation that led to a murder charge last fall.
Insurance Fraud Horror Stories Continued from page 6 Eight days prior to the accident, Summons filed a separate claim for rear left bumper damage to his vehicle with a separate insurance company, submitting pictures documenting the same damage attributed to the September 30 wreck.
Bertram said that he was putting his shotgun into his truck after a hunting trip in Gregory County when the weapon fired accidentally, striking Stickney in the abdomen. Bertram’s defense team argued the case had nothing to do with jealousy and that the insurance policy was Stickney’s idea to provide for her family in the Philippines if anything happened to her. “Bertram’s callous disregard for Leonila and his failure to show any sorrow or remorse are evident and unfortunate,” they said in a statement after the verdict was announced.
Allen told investigators she did not know any of the passengers in Summons’ vehicle while Johnson, Jones and Beene said they did not know Allen. Investigators later determined that Allen and Beene lived across the street from each other and that Beene and Jones are AIANC’s STREET WISE Page 7 of 21
Continued on page 8 October 2016
More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com Insurance Fraud Horror Stories Continued from page 7
Weight Lifting Cop Guilty of Workers’ Compensation Fraud Jacob Finerty, 28, a Santa Barbara police officer was sentenced to 120 days in jail, five years of probation and has to pay $115,669 in restitution to the City of Santa Barbara. The Santa Barbara County District Attorney’s Office established that Finerty, 28, claimed to have injured his lower back during an on-duty traffic accident and said he was unable to perform his duties. However, he was seen lifting weights and even performing in strength and wrestling competitions. Photos and videos from those competitions were posted on social media.
After receiving a complaint from an insurance company, investigators with the Department of Insurance, Investigation Division discovered that McCloskey, a licensed insurance broker, failed to remit the entire insurance premium he received from policyholders to the insurance company from October 1, 2009 through December 31, 2011. The insurance company extended coverage to the policyholders affected by the shortage in premiums. The department revoked McCloskey’s license on December 6, 2012. Sentencing is scheduled for December 1, 2016. This case was prosecuted by the Ventura Superior Court. Continued on page 9
Agent Guilty of Defrauding Clients Martin McCloskey, 69, of Piñon Hills, California pleaded guilty to three felony counts of grand theft and theft of fiduciary funds after defrauding his customers by failing to remit to insurance companies more than $58,000 in premiums he collected for commercial property and liability coverage.
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Grimmesey, 42, of Santa Maria, a former licensed insurance agent employed as a customer service representative for an insurance agency, allegedly stole premiums from policyholders who paid cash for insurance premiums and then used other customers’ credit cards to repay the stolen premiums.
Insurance Fraud Horror Stories Continued from page 8
Insurance Agent Pleads Guilty to Stealing Premiums - Only 90 Days in Jail Melissa Grimmesey on September 9, 2016 pleaded no contest to one felony count of grand theft, one felony count of identity theft, and one felony count of unauthorized access to a computer system. Grimmesey will be sentenced on October 14, 2016 to 90 days in custody, three years felony probation, and ordered to pay fines and fees. In addition, pursuant to California Insurance Code section 1748.5(e)(2) and18 USC § 1033, Grimmesey is no longer a licensed insurance agent and is banned from participating in the insurance industry. AIANC’s STREET WISE
An investigation by the California Department of Insurance Investigation Division revealed Grimmesey allegedly recorded the cash payments in the computer system and then deleted the transactions to avoid detection. The case was prosecuted by the Santa Barbara County District Attorney’s office.
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More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com Insurance Fraud Horror Stories Continued from page 9
Kristy Lynn and Michael Alger may wish they never made this shopping trip. Michael pulled their Chevy Malibu into a Sheetz store. The Hagerstown, Md. couple got into an altercation with another driver. Michael backed up, hit a dump truck, then pulled forward and hit the other guy’s car. Michael next hit the driver, who was standing outside his car. The guy was pinned between his vehicle and the Malibu. The Algers sped off, and the dump truck followed until police pulled over the couple. The victim suffered a broken leg that needed surgeries. Kristy filed a claim with their insurer, saying she drove. She hit the truck and a pole, she said, omitting hitting the guy. The insurer pegged the Malibu’s damage at $3,032. The victim later contacted the Algers’ insurer to file his own claim. The insurer realized the Algers had filed a false claim. The store’s surveillance video confirmed the incident as well. Kristy received 3 months of home detention. Michael was handed 8 years for hitting the guy.
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ID Theft & WC Fraud Wanted and on the run, David Abitua stole the identity of Jose L. Vasquez and lifted workers-comp money under that alias. Abitua lied to his doc and used a false SSN to steal comp money for nearly 3 years. He had a longlist of warrants for drug, booze and traffic offenses. Abitua received 6 months of community control for the comp charges, the Ohio Bureau of Workers’ Compensation announced.
Joshua West fought to his final breath. Hovanes Maskovian needed a tire iron, knife, teeth, car and gun to kill his boyfriend for $2.5 million. West broke up with Maskovian after 7 years together, though the Los Angeles-area pair kept living together to conserve money and pay bills. They’d bought $2.5 million in life coverage on West when they were romantically involved, with Maskovian the beneficiary. Maskovian enlisted his brother Hachik and a crony to help murder West. They lured him to Sun Valley. West was beaten, his throat slashed, bitten, run over by a car and shot in his heart. West’s body was dumped on a road. Hovanes called a State Farm agent the day before West’s murder to ask about the insurance policies. A pair of gloves found in a canyon 2 miles from the murder scene tested positive for DNA linked to Hachik and West. Hovanes and Hachik received life without parole. A crony awaits trial.
Guilty of $400,000 Fraud by City Employee Robert Otterson, a former city fleet supervisor in Philadelphia has admitted to theft and conspiracy charges in a scheme that prosecutors say steered work to an auto body shop that overcharged the city more than $400,000. Otterson pleaded guilty September 15, 2016 to stealing from city inventory. Authorities say Otterson qualified an auto body shop for work that didn’t have the necessary equipment. The shop had been run by Ronald Galati Sr. and his son, Ronald Jr. Authorities say Otterson told them what to bid and shared in the ill-gotten proceeds. Galati Sr. is serving more than 20 years in prison for attempting a failed hit on his daughter’s boyfriend. He pleaded no contest to charges. Galati Jr. pleaded guilty. All three are to be sentenced in December. Continued on page 11
Questions? Contact Eddie K. Emmett at eddie@fyiexpress.com or (770) 312-2342. HU
UH
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More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com Insurance Fraud Horror Stories Continued from page 10
“I live my life to cheat insurance companies — my high every day is to cheat insurance companies.” That was the motto of reputed mobster and South Philly body-shop owner Ron Galati. He made a tidy living using deer carcasses to stage vehicle crashes that saw auto insurers falsely charged $5 million. He also hired thugs to murder 2 witnesses during his trial, though the hit never came off. Galati claimed vehicles were damaged in deer crashes. He stored deer carcasses, hair and blood at his body shop. His cronies poured the blood over cars, simulated crashes and took “Hollywood photos” for insurers. Geese, dogs and chunks of metal and concrete also were involved, as were hurtled cartons of fruit. Galati favored single-vehicle crashes because insurers considered them “no-fault” and paid claims without raising premiums. Galati also gave towtruck drivers a list of his customers. The drivers vandalized the customers’ cars and towed them to his shop for bogus insurer-paid repairs. A Philly police officer created fake crash reports. Adjusters and the towtruck drivers also were on the take. Galati pleaded no contest this week to bilking 18 insurers, and to the planned hits.
A driver said a truck hit his Mercedes CLS500 while he was driving along a parkway. Surveillance caught the driver delivering the undamaged Mercedes to Wilson. The car mysteriously left Wilson’s garage with substantial damage to its right side. Progressive paid more than $13,000 on that claim. Wilson stole $85,000 all told, pleaded guilty and received 23 months of intermediate punishment.
Auto insurers peeled back onion layers of fake identities to get at the truth of setup crashes masterminded by Cristopher Santiago Sanchez-Becerra. The Stockton, Calif. man helped stage dozens of wrecks that bilked insurers out of at least $210,000. He and cohorts used 2 or 3 vehicles that caused $5,000-$10,000 in damage to each vehicle. They used a similar cover story after each setup. The ring also used aliases, plus false identities and addresses. And they used fake identities to register the vehicles and buy insurance. Ringleaders repaired the vehicles at body shops owned by Sanchez-Becerra or a crony. They did shoddy repairs, charging far less than insurers paid out. Sanchez-Becerra pleaded guilty and could spend up to 20 years in prison when sentenced Nov. 28. Others still face trial.
Pay Up or Get Canceled?
Body-shop owner Franklin Thomas Wilson fleeced insurers before he even began work. The Darby Borough, Del. man wrote up estimates for customers, then took the vehicles to an empty garage — across from the police station. He drove the vehicles into a pole or beam to inflate the damage. Sometimes he drove a forklift into the vehicle. Wilson did the damage just before an adjuster inspected the vehicles. He repaired the vehicles for a much-lower price after the claim was paid, pocketing the balance. He also paid kickbacks for customer referrals. A police informant allegedly earned $10,000 by referring up to 20 people.
AIANC’s STREET WISE
Audits showed more premiums were due, agent Charles Gabel told clients. So they dutifully paid up, more than $58,000 worth. Jones Produce forked over payments of $26,314 and $21,350 to the Fremont, Ohio agent. Mauch Farms paid more than $11,000. Except that the clients never owed the money — their premiums were paid in full. Gabel forged premium invoices and stole the money for personal gain, the Ohio insurance department says. Medical and family financial problems drove him to steal the premiums. He received 3 years of community control and surrendered his agent license. He avoided jail in order to find employment and repay his clients.
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More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com In Sales and Business You Do Whatever You Have to Do to Win by John Chapin Recently Shaunae Miller of the Bahamas won the women’s 400 meters at the Rio Olympics by diving over the finish line. Some say she fell, others say she dove, but either way, she won, as it is legal to fall, dive, or do whatever you have to in order to get over the finish line first. Still, some people cried “foul” because, to them, this didn’t seem fair. This situation, Deflategate, and other examples raise the question of right and wrong, and fair and unfair when it comes to winning in sports.
What about when it comes to winning in sales and business? Is there a gray area? Is there a line somewhere that we don’t cross? Or is selling in the same category as love and war where “all’s fair”? The Rules for Pushing the Envelope when Competing Rule 1: Know the Rules and Laws Intimately You do whatever you need to do to win as long as it is legal and ethical. Because of this it is very important to have a complete understanding of the rules and laws. I find that people who say “that’s not fair” when a competitor uses a creative but legal tactic against them to win, simply weren’t aware of the tactic and would have been the first to use it had they known. I also find that many people incorrectly interpret rules and laws as an excuse for not stepping out of their comfort zone or going above and beyond. You must use all rules and laws at your disposal to win. Shaunae knew it was legal to dive, so she did, and she won. You also need to know what isn’t in the rule book that you might be able to use to your advantage. For example, when I was eight years old, my best friend David and I played minorleague baseball. One day, when I was the pitcher and he was the catcher, David, who is now a sports announcer, and even at 8 knew more about sports than most adults, had the bright idea to intentionally walk the other team’s super-star player. He called for time-out, marched out to the mound and said to me, “John, let’s walk this guy. When I stand up and step off to the side, just throw the ball to me.” He did, and I did, and after the first pitch the coach from the opposing team erupted and came flying out of the dugout screaming and yelling that “we couldn’t do that.” The coaches and umpires, unable to find any rule against it in the rule book, allowed us to intentionally walk the batter, but just this one time. Continued on page 14 Crossword Solution on page 21
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More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com You Do Whatever You Have to Do Rule 3: Sell on Price
Continued from page 12 Another example came when I was in Cub Scouts. The highlight of that experience was winning the Pinewood Derby. I won by knowing the maximum weight for a car was 5 ounces, a little something about aerodynamics, and the fact that graphite would help my wheels turn with the least friction. Okay, correction, my dad knew all that. In any case, we crafted the car for aerodynamics, my dad filled the cockpit with clay, bolts, and nuts until we were at the maximum weight, and I put graphite on the nails holding the wheels… and WE won. I remember looking up the rules to identify the maximum weight and whether or not it said anything about graphite: 5 ounces, and nothing on graphite, so we used it. Know the rules and the laws and be resourceful without crossing ethical or legal lines. Oh, and surround yourself with smart people like David and my dad. Rule 2: Tell Horror Stories Related to the Competition One of the first rules of sales is that you NEVER bad mouth the competition. I agree. This is not the same as bad-mouthing the competition. You’re going to tell stories about bad results of some of their common practices, not attack them personally. You’re going to use these stories when a customer is in danger, or you are about to lose a major account and you are trying to save it. In these situations, the gloves come off and everything is legal. You’re looking for situations in which customers have been hurt by something the competition did or overlooked. For example, three years ago a friend switched his insurance and saved $300. He was told it was exactly the same policy; the new company was simply less money. After he had a serious motorcycle accident, he found out it wasn’t the same. The new company had an exclusion so he wasn’t covered under his umbrella policy when he was on his motorcycle. The key here is to raise a reasonable doubt. You have to show the prospect the potential pain to going with the competition. Is there something that can hurt them like in the story above? If so, tell a story of someone who got bit by their mistake. If you’ve been in your business for any length of time, you have some solid stories of people who got hurt by the competition in one way or another. If you don’t personally have stories, go to others who have been in your business a while that have good stories. Oh, and if you catch the competition outright lying, let the prospect know and have them get the lie in writing to cover their butt.
AIANC’s STREET WISE
The last thing you want to do is outright cut your price. Typically if you are dropping price you are also reducing services or removing options or extras. That said, as an exception, you can drop price as a “last” resort. I remember presenting a new bank branch proposal to a Senior V.P. and he said, “If you can knock $1500 dollars off, I’ll do it.” Considering it was a $165,000 order, I said, “Done. I just need your approval right here.” Rule 4: Leave No Stone Unturned You have to go to bed at night knowing you did everything you could to get the sale. If there was something else you could have done, but you didn’t, you’re always going to wonder if that would have made the difference. So make one more call, spend a little more money making something look better, and put in a little more effort and energy to make sure you do all you can to win. NOTE: Never outright break a rule or law, get caught in a lie, or otherwise sacrifice your ethics. Also, always err on the side of caution. At the end of the day, all you have is your reputation and character. John Chapin is a sales and motivational speaker and trainer. For his free newsletter, or if you would like him to speak at your next event, go to: www.completeselling.com John has over 29 years of sales experience as a number one sales rep and is the author of the 2010 sales book of the year: Sales Encyclopedia. For permission to reprint, e-mail: johnchapin@completeselling.com. John Chapin # 1 Sales Rep w 29+ years’ experience, Author of the 2010 sales book of the year: SALES ENCYCLOPEDIA (Axiom Book Awards) - The largest sales book on the planet (678 pages). 508-243-7359 - 24/7 johnchapin@completeselling.com www.completeselling.com LINKEDIN: once logged in find me under: johnchapin1
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October 2016
More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com One very clear message came out of the exercise. They were not just trying to just fix the car. They also wanted to fix the customer. They wanted to move the customer from unhappy to happy. From angry or disappointed to pleased. From frustrated to fulfilled. At Lexus, they recognized that a broken car can also mean a broken customer. The challenge is to fix both. Sometimes a customer is legitimately upset. For example, they may have brought their car in more than once to have the car serviced for the same problem. So, what will make them happy? Maybe the customer wants a refund for the repairs or a credit for a future repair. Or, maybe the customer doesn’t want any financial compensation. They just want their car fixed and taken care of by a service rep who truly cares, shows empathy (that one’s important) and apologizes for the inconvenience.
There is an old customer service saying that has to do with whenever someone disagrees with a customer: You’re not trying to win an argument. You’re trying to win a customer. You really can’t win an argument with a customer. It’s not that the customer is always right. They aren’t. If you’ve followed my work, you know that I believe the customer is not always right. So, how can you let them always win an argument? First, don’t get in the argument to begin with. Sure, you can win the argument, but you lose the customer. But, what you can always do is be respectful. You can let the customer keep their dignity. You can agree to disagree. You can work toward a mutually agreed upon solution. In short, you win the customer, not the argument. This concept became even more evident to me as I sat in on a meeting with one of the top automotive manufacturers in the world, Lexus. They are known for great cars and incredible service. At one of their corporate meetings they had a roleplay exercise where some of their employees pretended to be unhappy customers and others pretended to be employees at a dealership. It was fascinating to watch great training come to life, as the employees representing the dealership managed the customer’s complaints with skill and tact.
AIANC’s STREET WISE
You don’t have to be in the car business to take advantage and learn from Lexus. Learn what will make the customer happy. It may be as simple as just asking. (You don’t know if you don’t ask.) It’s definitely not arguing with the customer. Find out what’s behind any frustration, disappointment, and even anger. Talking it through with the customer, rather than pointing blame or making excuses may be the simple solution. Yes, you may be in a situation that is more complicated than a car repair. Yet, however simple or difficult the situation is, don’t argue. You might win the argument, but you may lose the customer in the process. Look for the solution that is reasonable and is a win/win for both you and your customer. Shep Hyken is a customer service expert, keynote speaker and New York Times bestselling business author. For information contact or www.hyken.com. For information on The Customer Focus™ customer service training programs go to www.thecustomerfocus.com. Follow on Twitter: @Hyken Copyright ©MMXVI, Shep Hyken – www.Hyken.com Shep Hyken, CSP, CPAE is a customer service expert, hall-offame speaker and New York Times and Wall Street Journal bestselling author. He works with organizations to build loyal relationships with their customers and employees. He is also the creator of The Customer Focus, a customer service training program that helps organizations develop a customer service culture and loyalty mindset. For more information contact (314) 692-2200 or www.Hyken.com
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More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com
Wouldn’t it be nice to have “mulligans” in E&O? With golf season on the horizon (even in Utica), the subject of “mulligans” is sure to come up. A mulligan is a “do-over.” If a casual golfer (not a pro) hits a bad shot, he or she can call a mulligan and hit the shot over. The premise is that the second shot will be better than the first, and the first shot won’t count. Wouldn’t it be nice to have mulligans in errors and omissions? After an E&O claim is made, the producer or account exec could get a mulligan – a “do-over” – to fix things. For example, if there was no documentation in the file or the documentation is not at the level it should be. Possibly, the issue involves a producer that misspoke as to how coverage would apply; he or she could go back, correct themselves and all would be forgiven.
So what does this essentially mean? It means when agency staff – producers, customer service representatives, accounting folks, receptionist, etc. – performs a particular task, if the task should be documented, it gets documented. Clearly, the odds of an agency prevailing in an E&O matter are strengthened when documentation in the file is handled promptly, professionally and accurately. The odds are also enhanced significantly when the file reflects documentation back to the customer, memorializing the various conversations and decisions. Agencies and their staff must be extremely serious about this and make every effort to have a culture and commitment that tolerates nothing but the best because, in the world of agents’ E&O, unfortunately, there are no mulligans.
In an E&O claim a couple of years ago, a CSR indicated during trial that she had spoken with a restaurant owner about the need for liquor liability but when asked where the documentation of the conversation was, she admitted, “I can’t document everything. If I did, I would never get any work done.” As a result, there were no notes in the system reflecting any discussion on the offer and declination of the liquor liability coverage. In all probability, the bar owner knew he did not have coverage for liquor claims, but with nothing documented, the legal system found the agent liable and a settlement was reached. Do you think the producer and CSR wish they had a couple of mulligans to fix some areas after the claim was made against them? Without a doubt – but that’s not the way it works. When an E&O claim is made against an agency, the file “is what it is.” No “do-overs!”
More E&O Tips at http://www.agentseotips.com
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Go to www.EandOQuote.com for more information
More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com Click here to review a PF&M analysis of the CP 10 30-Special Cause of Loss Form Collapse exclusion and the Additional Coverage-Collapse.
Apartment buildings abounding First, clearly identify the problem. Then move forward in finding the solution The Producer Online IN ACTION is a monthly reminder of how you can turn the knowledge gained from The Producer Online into powerful sales opportunities.
It was damaged but was in covered?
When a tenant moved out Montague's property manager noticed that the wooden terrace attached to the unit was sagging and separating from the building so a property claim was sent to New Hampshire Insurance Company. New Hampshire denied the claim because, in their opinion, it was due to wear and tear, rust, corrosion and wet and dry rot excluded causes of loss. Montague argued that the loss was due to hidden support beam failure and therefore was covered. Click here to see which cause of loss argument prevailed.
Collapse - the difficulty in defining the cause of loss.
The demand for apartments is extremely high in most parts of the United States. Vacancy rates are at an almost all-time low and rental values continue to grow. Well-constructed insurance programs for these building owners are also needed. The Producer's Commercial Lines Risk Evaluation System Questionnaire includes an inventory that tracks with the description of building and business personal property in many ISO forms. This inventory doesn't replace the insured's own inventory but may help to reduce the premium because building items are normally priced much less than business personal property. Click here to review the property inventory of the Producer's Commercial Lines Risk Evaluation System Questionnaire.
A review of the coverages Coverages Applicable is an excellent product to use in training your agency staff about a particular risk category. The coverages to consider listing provides easy clicks abbreviated explanations of coverages that might be just enough to get you started with a new customer. It also provides links to the more in-depth discussions provided within PF&M. Click here to review the Real Estate and Rental Property category in Coverages Applicable.
The Collapse cause of loss has been modified frequently over the years because of how important the coverage is and how difficult it can be to define. The current ISO method used with CP 10 30-Special Cause of Loss Form is to first exclude collapse and then to add it back as a specifically described coverage. This way provides expansive coverage for collapse but not without limitations.
AIANC’s STREET WISE
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For 135 years Rough Notes has been dedicated to making you a better agent. Become the coverage expert with the Producer Online-Plus Producer Online-Plus Includes Commercial Lines Risk Evaluation Survey Personal Lines Risk Evaluation Survey Policy Form & Manual Analysis Coverages Applicable The Insurance Marketplace Marketplace Cybercast
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More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com October 3, 2016 -- Medicare Open Enrollment Period Oct. 15 – Dec. 7 RALEIGH -- Change is a part of everyday life and change may be necessary to get the most out of your health care benefits. Each year during the Open Enrollment Period, Medicare beneficiaries have the opportunity to compare and evaluate their current plans and make changes as necessary. Just as your health needs may change... September 29, 2016 -- State Leaders Meet to Strengthen Fire Service RALEIGH -- Insurance Commissioner and State Fire Marshal Wayne Goodwin met with fire service leaders from across North Carolina as part of the Volunteerism Steering Committee at Elon University in Burlington, NC on Sept. 29, 2016... September 21, 2016 -- Insurance Commissioner Opposes $600 Million Rate Increase RALEIGH -- Insurance Commissioner Wayne Goodwin filed a response to the appeal filed by the Rate Bureau in the North Carolina Supreme Court. The appeal is based on the North Carolina Court of Appeals decision affirming Commissioner Goodwin’s rejection of a 2014 homeowner’s insurance rate increase of approximately $600 million... NC DOI News
September 15, 2016 -- Commissioner Goodwin Announces $3.6 Million BCBSNC Fine
October 7, 2016 -- Wilmington Man Accused of Claiming Fraudulent Vehicle Damage RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Randall Sanford, 38, of 1303 Wellington Ave., Wilmington; he is charged with one count each of insurance fraud and attempting to obtain property by false pretense... October 7, 2016 -- Georgia Man Accused of Staging Car Theft in Fayetteville RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Jeremy Joseph Keeton, 29, of 61 Lanier St., Columbus, GA; he is charged with one count each of insurance fraud and filing a false motor vehicle theft report in Cumberland County... October 4, 2016 -- Goodwin Encourages North Carolinians to Prepare for Hurricane Matthew RALEIGH -- With Hurricane Matthew shifting toward North Carolina, Insurance Commissioner Wayne Goodwin reminds all North Carolinians to be prepared for severe weather by visiting www.NCHurriClaims.com or calling the Department of Insurance at 855-408-1212... AIANC’s STREET WISE
RALEIGH -- Insurance Commissioner Wayne Goodwin today fined Blue Cross Blue Shield of North Carolina $3.6 million as part of a Voluntary Settlement Agreement. The agreement was signed by Commissioner Goodwin this afternoon... September 15, 2016 -- Surry County Woman Submits Duplicate Claim RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Kathryn Taylor Reynolds, 39, of 157 Devotion Estate Way, Dobson; she is charged with one count each of insurance fraud and obtaining property by false pretense in Davidson County... September 7, 2016 -- Wilmington Man Left the Scene of an Accident RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Dalton Bress, Jr., 25, of 909 North 30th St., Wilmington; he is charged with one count each of insurance fraud, driving with a revoked license and hit and run in New Hanover County...
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October 2016
More Tips & “How-To” videos at www.AllianceInsuranceAgentsNC.com August 31, 2016 -Robeson County Woman Vandalized Her Own Car RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Tamara Brayboy, 30, of 1801 Cabinet Shop Road, Maxton; she is charged with one count each of insurance fraud and obtaining property by false pretense... August 30, 2016 -Fayetteville Agent Charged with Falsifying Insurance Applications RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of James Stevie Spears, 44, of 3316 Auburn Drive, Fayetteville; he is charged with one count each of obtaining property by false pretense and... August 25, 2016 -Hoke County Man Charged with Insurance Fraud RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Travis Lee Richmond, 43, of 180 Westminster Drive, Raeford; he is charged with one count of insurance fraud... August 24, 2016 -- Durham Woman Charged Claims Fraudulent Vehicle Damage RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Trudy Brunner-Sharpe, 69, of 5901 Craig Road, Lot 86, Durham; she is charged with two counts of insurance fraud and one count each of obtaining property by false pretense and attempting to obtain property by false pretense... August 24, 2016 -- Vance County Woman Charged with Insurance Fraud AIANC’s STREET WISE
RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Tarish Renay Billups, 40, of 371 Ragland Lane, Henderson; she is charged with one count of insurance fraud... August 19, 2016 -- Johnston County Agent Charged with Five Counts of Insurance Fraud RALEIGH -- Insurance Commissioner Wayne Goodwin today announced the arrest of Catherine Ann Davis, 59, of 5240 Glendale Road, Kenly; she is charged with five counts each of insurance fraud and obtaining property by false pretense...
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