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‘And that’s why they’re no longer covered’: Insurance adjuster discovers mom is committing fraud by pretending to be her own daughter

Honesty might not always be the best policy after you've already broken the law.

images via tiktok

Nobody likes dealing with insurance. Every version of the awful but necessary system is almost always a headache. But no matter how much you detest working within the system, it’s important to play by the rules.

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TikTok creator @Alexz.Wo is a licensed claims adjuster working out of Florida. An auto claims specialist, she uses her platform to help spread awareness about how to work within the system to get what you want. More importantly, she posts ample videos describing exactly how one shouldn’t try to game the system – and what happens when people think they can outsmart their insurance adjusters.

Despite the absence of the customer’s side of the conversation, Alexz.Wo’s professional investigation gives more than enough context for the situation. Sometime recently, Wo’s client was in an accident, but it’s not her customer on the line.

Instead, Wo is dealing with the claimant, AKA the person trying to get the cash to fix their car – only it isn’t actually the person who was in the wreck. Instead, it’s the driver’s mother who, up until this point, has been pretending to be her daughter.

“I called in to speak with Jamie, you answered her phone saying that you were Jamie. Then we did the recorded statement where you ‘confirmed’ you were Jamie again… but you’re not Jamie.” Glancing around in abject confusion as the woman defends her action, Wo can’t help but ask, “Why… Why would you do that?”

To be clear, insurance fraud is a felony, one carefully monitored by the long arm of the law. Not only can it result in jail time, but also requires fraudsters to pay back any money that the insurance agents might have sent out. It comes with a sentence of up to 5 years in state prison and a hefty fine of 50,000 in addition to any restitution the States Fraud division might require.

As Wo tries to discern what is going on, she quickly realizes that it’s an overzealous mom in charge of the whole debacle. In a bid to protect her daughter and complete the investigation on her behalf, the protective mom pretended to be her daughter to get the ball rolling. Maintaining her cool and showing some incredible customer service skills, Wo tells the woman,

“I understand that you may have been concerned about the process, but what you did is considered fraud. When people are calling in for a specific person to confirm an investigation where there could be personal gain from one party to the other, you can’t impersonate someone and say that you are someone when you’re not. That is fraud.”

Plenty of users in public-facing official accounts shared their own frustration with impersonators trying to nab some extra moolah. LadyLoper added her two cents, “ugh that happens all the time at the bank. ‘But um their parent, why can’t I get info on their account.’ well, cause it’s not your account.”

“We get these calls and now the the uptick in fraud, it immediately goes to our fraud department and nothing can be done on the policy,” an unnamed user shared.  

“The amount of parents who try to do this at our doctors office is unreal,” another user added to the frustrated masses.

Coming from the other perspective, Arelys R added, “I would always help my mom with important phone calls. I never impersonated her, I always started with ‘I’m calling on behalf of my mother (insert her name her) and then tell them my name. Common sense?”

In her comments, Wo diligently answered viewers’ questions. When asked how easy this kind of insurance fraud was to commit, she said she would never have known if the woman hadn’t called back. In fact, she thinks the only reason mom came clean was because of the recorded statement that was sent to Jamie’s insurance company.

At the end of the day, we’d like to encourage you not to commit any crimes. But if you do, for the love of all that is holy, don’t tell the insurance adjuster about it.  

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