Merhaba arkadaslar. Benim insurance firmam ile bir sorunum var aramizda bilgi sahibi arkadaslarin bana yardımcı olacagını umuyorum. Ben uber şöförüyüm. Ufak bir trafik kazası yaşadım ve insurance firmam beni cover etti. Bu olaydan 1 yıl sonra bana bir mektup göndererek bu kaza hakkında investigator tuttuklarını ve benim kaza anında uber yaptıgımı tespit ettiklerini ve benim yalan beyanda buluduğumu, uber yaptıgım icin bu kazanın maliyetini kendilerinin degil uber insurancenın karsılaması gerektigini söyleyip bana ödedikleri 1400$ lık tutarı 21 gün içinde geri göndermem gerektigini eger göndermezsem bana dava açabileceklerini söylediler. Proof olarakta uberle iletişime geçip mail yoluyla aldıkları şu cevap var ; his account may has been active. Bende o akşam uber yapıyordum ama o anda arabamda müşteri yoktu işlerin daha karışmaması için o akşam uber yapmadıgımı söylemiştim. Kendileriyle iletişime geçtim ama bu konuda yapacakları birşey olmadıgını söylediler. Ben bu parayı kendilerine göndermedim, gönderseydim fraud suçunu kabul etmiş olacaktım. Eğer beni mahkemeye verirseler bu olaydan başıma büyük şeyler gelir mi ? Internette okudugum kadarıyla insurance firmalarının kendi müşterisini dava etmesi cok az rastlanır bir durummuş fakat her olasılık mümkün. Bu konuda bilginiz varsa yardımcı olursanız sevinirim. ne derece bir durumun içerisinde olduğumun farkında değilim. Belki çok büyük belki çok sıradan bir durum fakat internette aynı tarz bir vaka görmedim. Şimdiden teşekkur ederim.
AŞAGIDA BANA GONDERDİKLERİ MEKTUBU GÖREBİLİRSİNİZ.
Dear Mr. :
Please be advised that your claim for damage to your Honda Accord related to the alleged loss on July 21, 2019 has been investigated by our Special Investigations Unit (SIU). The investigation is complete and SIU has concluded, among other things, that false and misleading information was provided to us regarding this claim. Specifically, the investigation concluded that you misrepresented the use of your Honda to NJM as a non-TNC/rideshare vehicle when, in fact, you were engaged in ridesharing, Phase 2, through Uber when the loss occurred.
New Jersey Manufacturers Insurance Company (“NJM”) does not provide coverage for any party who has made fraudulent statements or engaged in fraudulent conduct in connection with any accident or loss for which coverage is sought. Based on the policy of insurance and the SIU report, NJM will not make any additional payment in regards to this claim.
In conjunction with the above, NJM’s investigation of this claim has revealed facts establishing violations of Pennsylvania’s Insurance Fraud Statute, 18 Pa. C.S.A. § 4117.
An individual violates 18 Pa. C.S.A. § 4117 where he/she: ...
(2) Knowingly and with the intent to defraud any insurer or self-insured, presents or causes to be presented to any insurer or self-insured any statement forming a part of, or in support of, a claim that contains any false, incomplete or misleading information concerning any fact or thing material to the claim.
(3) Knowingly and with the intent to defraud any insurer or self-insured, assists, abets, solicits or conspires with another to prepare or make any statement that is intended to be presented to any insurer or self-insured in connection with, or in support of, a claim that contains any false, incomplete or misleading information concerning any fact or thing material to the claim, including information which documents or supports an amount claimed in excess of the actual loss sustained by the claimant.
[18 Pa. C.S.A. § 4117(a)]
2019-157936 F10123526 07/21/2019
NEW JERSEY MANUFACTURERS INSURANCE COMPANY
April 22, 2020 Page 2 of 2
Under Pennsylvania law, any insurance company damaged as a result of the above, may recover compensatory damages, including reasonable investigation expenses, costs of suit and attorney’s fees. The insurer may also be entitled to recover treble damages. 18 Pa. C.S.A. § 4117(g).
In connection with this claim, NJM previously issued payment to Auto Body, Inc. in the amount of $1,404.99 for the damages to your vehicle. NJM now denies your claim due to fraud; therefore, we demand that you reimburse us for this amount. Please remit payment in the total amount of $1,404.99 to NJM. Payment should be forwarded to the NJM adjuster responsible for this claim, Tabitha
The claim number must be referenced on any check, money order or other form of payment besides cash. Please send payment within 21 days of receipt of this letter to avoid any further action by NJM. Failure to remit payment as outlined above may result in court action against you, in which treble damages are sought pursuant to 18 Pa. C.S.A. § 4117.
Any action taken by an NJM employee or agent with regards to the facts or evaluation of coverage under the policy should not be deemed a waiver of any terms, conditions, exclusions or other provisions of the policy. Furthermore, the grounds for our coverage position set forth in this letter are not intended to limit NJM’s right to assert additional grounds for disclaiming coverage for all or part of the claim, even if not set forth above.