In special investigations, claims can range in size and scope such that no two are alike. Severe weather, however, is the great equalizer. In the event of a hailstorm, like those that befall the prairies seasonally, claims begin to pour in, requiring specialized attention, specific expertise, and a keen sense for potential fraud. Xpera’s Special Investigations Unit (SIU) gets put to work before the clouds clear to properly assess damage, provide objective findings, and mitigate potential fraudulent claims filed in the aftermath of severe weather. What follows is one such investigation.
On the Radar:The Nature of the Claim
Following a severe storm in mid-July, Xpera was retained to investigate the hail damage claim, obtain the opinion of a hail damage expert, and conduct any further investigation as required. Considering the totality of potential damage from the hailstorm, the vehicle could have been written off entirely.
Following the initial review of the claims file documents, the Xpera SIU identified various indicators of potential fraud, requiring an in-depth investigation. An immediate identifier was the extensive damage allegedly sustained, yet inconsistent with that of normal hail pattern damage. Further, pictures taken by the appraiser and pictures taken by the Insured did not match in terms of how each portrayed the severity of the damage.
Tracking the Patterns: Investigation Highlights
The Investigator began by inspecting the Insured’s vehicle and further documenting the damage with independent photographs particular to the scope of the investigation. The damages were consistent with those noted on the appraisal estimate that had been provided. However, not all the damages reported and recorded were consistent with hail damage observed on other vehicles caught in the same storm in the same region at the same time.
Seeking fresh perspective, Xpera conducted an interview with the experienced and qualified Hail Damage Estimator who believed the damage observed on the vehicle had been exaggerated by vandalism. Additionally, Xpera contacted the Insured and conducted an audio interview with them to gather and document a full account of their side of the story.
The Rising Tides: What We Heard from the Insured
The Insured explained that their vehicle had been parked outside of the home when the storm began. Consequently, the Insured explained, windows had cracked and broken from the impact of the storm. However, the initial pictures the Insured provided showed windows intact, contradicting their statement.
Despite the severity of the damage, the Insured insisted that the hailstorm was the sole cause of the damage on the vehicle’s painted surfaces, and they did not believe anyone would vandalize the vehicle windows, nor knew what had happened. On numerous occasions, the Insured also stated that they would be willing to replace the two side windows if that accelerated the claim.
Beyond the Clouds: The Investigation Goes Deeper
Seeking additional expertise, Xpera brought in Pario Engineering & Environmental Sciences, a forensic engineering firm, to confirm whether the damages sustained to the vehicle could be entirely attributed to hail. An Engineer joined Xpera to inspect the vehicle once again.
The vehicle was identified to have many small indentations on the hood and on the passenger’s side of the vehicle. The driver’s side was largely undamaged, most likely as a result of the vehicle’s orientation during the hail event.
The dents on the vertical windshield support were approximately equally spaced and were restricted to those higher magnitude dents of approximately 4.5-6.5cm in diameter. This could have potentially occurred as a result of vehicle orientation and wind speed during the hail event; however, the equidistant impact points and larger magnitude of damage coupled with point loss of paint were also identified to be consistent with mechanical tool damage rather than hail impact.
On the same passenger’s side of the vehicle, above the rear wheel well, large approximately equidistant denting was observed. These dents were approximately the same level of damage as the identified damage on the vertical windshield support, with point loss of paint identified in each of these larger impact locations.
The damage to the rear wheel well was not consistent with the remainder of the identified hail damage on the vehicle. The rear wheel well dents were approximately 5-7cm in diameter and were approximately 3-4 times deeper than the damage on the passenger’s side doors, which were located on the same plane. It would have been expected that the rear wheel would have been exposed to very similar, if not identical, conditions as the passenger’s side doors.
Once again, these dents on the vehicle were more consistent with impact from a mechanical tool rather than hail or debris from a weather event.
The Engineer was able to postulate that the total damage to the vehicle was not consistent with the effects of a hailstorm.
After the Rain: Conclusion
Xpera reported its findings to the insurance company for their adjudication. This included discoveries from the initial onsite vehicle inspection, interview information obtained from the Insured, and conclusions formulated by the Forensic Engineer. The Xpera file was closed on time and on budget.
Claims like these emphasize the value of investigation to obtain objective evidence. Thanks to Xpera’s comprehensive investigation, including evidence-gathering, interviews, and the solicitation of expert opinions, this claim was resolved efficiently and conclusively. Hailstorms may not strike every day, but claims of this nature roll in every season. That is why Xpera’s SIU is an integral component of the successful management of a claim.
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Xpera’s Special Investigation Unit (SIU) consists of our most experienced and knowledgeable investigators. Contact our SIU team today to learn more, or for immediate investigative support for your claim. You can reach us at 1.888.842.8112 or investigation@xpera.ca.