We counsel insurance companies on suspicious claims and prosecute fraud perpetrators in Massachusetts. With the advancement in technology, detection of fraud has become increasingly more difficult, without a knowledgeable insurance fraud lawyer to uncover the facts leading to a success fraud defense. We work with insurance companies’ Special Investigative Unit, forensic engineers, fire investigators, and insurance fraud investigation experts, to uncover hard and soft fraud by policyholder and enterprises. Hard fraud involves some degree of planning and execution. Soft fraud in property insurance claims include exaggeration of the items damaged in a fire and is often referred to as an opportunistic fraud.
Fraud by a policyholder voids the insurance policy. In Massachusetts, Gen. Laws ch. 175, § 99 provides:
This entire policy shall be void if, whether before or after a loss, the insured has willfully concealed or misrepresented any material fact or circumstance concerning this insurance or the subject thereof, or the interest of the insured therein, or in case of any fraud or false swearing by the insured relating thereto.
In conjunction with an insurance companies’ investigation, an examination under oath of the policyholder may be requested. This exam is often referred to as an EUO. An EUO is a formal process used by insurance companies to interview the policyholder under oath about the claim. Attendance and cooperation at an EUO are condition precedent under a property policy of insurance to insurance benefits. In addition to taking EUO’s, we assist insurance companies in securing salient documentary records by obtaining court orders releasing information and records held by third parties.