Why Insurance Companies Deny Claims

Most claims filed with insurance companies get paid.  The insured is happy and the insurance company is moving on to the next claim and collecting premiums.  Honest people cannot understand why an insurance company would not pay a claim made by one of their customers.

The Insurance Journal published an article in October titled, “Former Pastor Sentenced To Prison For Setting Fire To Apartment In Insurance Scam.”  Reading the article helps a person understand why insurance companies sometimes deny a claim.. It is because sometimes people try to rip-off the insurance company.

The article tells us that a former pastor in Baltimore Maryland, has been sentenced to three years in prison for setting fire to an apartment he rented in Washington in a plan to collect insurance money.

The U.S. Attorney’s office, the U.S. Bureau of Alcohol, tobacco, Firearms, and Explosives, and the Metropolitan Police Department were all involved in the investigation and arrest of Jamel Carelock, who was the prior pastor.  He pled guilty in August 2018 to charges of arson, felony destruction of property, and second-degree insurance fraud.

According to the evidence in the case, on December 17, 2017, at about 1 in the morning, Carelock intentionally set fire to his apartment.  Carelock had soaked his mattress with gasoline and set it on fire, causing the damage to his apartment and surrounding apartments.

Other residents, including small children and elderly individuals were living and at home in the apartment complex and were forced to evacuate.  The law enforcement investigation showed that Carelock had applied for an insurance policy eight days prior to the fire.  He later filed a claim for more than $11,000 in damage to his property.  His intent to defraud the insurance company was, according to law enforcement, obvious.

In making the insurance claim, the evidence showed, Carelock presented materially false information to the insurance company.  Also, that Carelock misrepresented that he was not responsible for the fire, falsely claimed that he was in Georgia at the time of the blaze and falsely claimed that he lost personal items, including suits and a television.  The facts showed Carelock had removed those items from the unit before the fire, and he still had them at the time that he made the insurance claim.  Further investigation showed that Carelock’s cell phone was one mile away from the fire five minutes after the firm alarm was pulled.

Insurance companies will always look for reasons to deny a claim.  But, sometimes they are right.  When they are wrong, you need an experienced Insurance Law Attorney to help you.