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What action should be taken when a claim is suspected to be potentially fraudulent?

Request a re-investigation

Have the insured file a motorized proof of loss

In situations where a claim is suspected of being potentially fraudulent, the appropriate course of action is to have rigorous documentation and verification processes in place. This involves gathering additional evidence to substantiate the claim's validity. Requesting a motorized proof of loss allows for a clearer and more accurate representation of the loss from the insured party, which can be crucial in determining the legitimacy of the claim.

Other options, while they might seem relevant in certain contexts, do not appropriately address the immediate need to verify the authenticity of the claim. For instance, simply requesting a re-investigation without additional supporting documentation may not yield concrete results. Increasing the claim amount would not resolve suspicions of fraud and could exacerbate the situation by suggesting malintent. Informing law enforcement may be a necessary action at some point but typically occurs after substantial evidence has been gathered indicating that fraud is likely. Thus, focusing first on obtaining thorough documentation sets the foundation for a more informed and just process in handling the claim.

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Increase the claim amount

Inform law enforcement immediately

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