The Shoulder
The Shoulder
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Insurancepatient-wolf-522

Insurance flagged my claim for 'fraud investigation' — I have witnesses and photos??

I'm still shaking typing this out because I genuinely cannot believe what just happened.

About three weeks ago someone blew a stop sign and T-boned my driver's side at an intersection. I have two witnesses who stopped and gave me their numbers, I have photos of both vehicles, a police report, and the other driver's information. Everything by the book.

I filed a claim the same day. My adjuster was fine at first — collected everything, said the process would take a couple weeks. Then out of nowhere I get a call today saying my claim has been "referred to a special investigations unit" because apparently damage matching my vehicle's description shows up in some database tied to my plate from months before the accident.

I have never filed a claim on this car. Not once. I bought it used about a year ago and had a pre-purchase inspection done — zero noted damage. The damage on my car right now is clearly fresh, matches exactly where the other car made contact, and I have time-stamped photos from the scene.

My adjuster basically said her hands are tied, she can't tell me what the "matching damage" even is or where they got it, and she doesn't know who from the SIU will contact me or when. The shop already has my car and is waiting for approval to start repairs.

Is this actually a common tactic? Has anyone been through this? I feel like I'm being treated like a criminal when I literally did everything right. Do I just wait? Do I get a lawyer? I have nothing to hide but I also don't know how to prove a negative here.

14replies

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14 replies

  • 13
    keen-raven-127

    This happened to me about two years ago — almost identical situation. My claim got flagged because the prior owner of my car apparently had a fender bender and the insurer's database still had that damage description tied to the VIN. It took about a month of back and forth but once I sent in my purchase inspection report and some photos I had taken when I first bought the car, the investigation closed in my favor. The whole thing felt SO violating even though I knew I did nothing wrong. Hang in there, it does get resolved.

    • 11
      clear-hare-728

      I used to work in claims and I can tell you these database hits happen constantly with used vehicles. The system flags a VIN match and auto-escalates — the adjuster often has zero discretion, it's not necessarily her personally accusing you of anything. That said, the SIU investigator is going to want to verify your ownership timeline. Pull together anything that shows the car's condition when you bought it: inspection report, dealership paperwork, any early photos you have, even an old insurance declaration page showing when coverage started. The more you front-load that documentation, the faster this usually closes.

    • 9
      steady-optimist602

      This is exactly what I needed to read today. Thank you.

  • 7
    candid-owl-621

    The SIU referral is sometimes a legit fraud-prevention tool but it's also sometimes used to stall or deny valid claims. Don't assume good faith on their part. Keep EVERYTHING in writing from this point forward — follow up every phone call with an email summarizing what was said. Do not give recorded statements without understanding exactly what you're agreeing to first.

    • 17
      clear-bison-972

      Are you physically okay? I ask because people sometimes get so consumed by the insurance battle (understandably!) that they push through symptoms they're dismissing as stress. If you had any impact at all, even what felt minor, please make sure you've been seen. Soft tissue stuff especially can sneak up days or weeks later.

    • 18
      plain-grouse-749

      Get a dashcam. For the future, obviously — but also, start asking around whether any nearby businesses or traffic cameras captured the actual collision. That kind of footage shuts down any fraud narrative fast. And yes, consult a lawyer now, not after they deny you.

    • 5
      curious-owl-554

      I would be absolutely livid. You did everything right — called the police, got witnesses, documented everything — and now they're treating you like a suspect?? I'm so sorry you're dealing with this on top of recovering from the accident itself. Please don't just sit and wait quietly. Make noise, document everything, and don't be afraid to escalate.

    • 10
      patient-beaver-167

      For what it's worth — the fact that you have TWO witnesses plus a police report plus photos is genuinely a strong hand to hold. A lot of people going through SIU investigations don't have a fraction of that documentation. It feels awful now but you're actually well-positioned to come out of this clean. Sending you patience, because the waiting is the hardest part.

    • 0
      gentle-dreamer310

      Seconding this. The same approach worked for me last year.

  • 14
    hearty-stoat-732

    A few practical things worth knowing: your state likely has insurance regulations requiring they complete an investigation within a specific timeframe — usually somewhere between 30 and 45 days from the date you filed. You can look up your state's Department of Insurance website and find the exact rule. If they drag past that deadline without a written extension notice, that's something worth flagging. Also, you're generally entitled to a written explanation of any denial, and you have the right to appeal. None of this is legal advice, just general process stuff.

    • 0
      patient-wanderer377

      Solid advice. Getting it in writing is the part most people skip.

  • 9
    hearty-fox-994

    Not legal advice, but: if the investigation drags on and your car is sitting at a shop accruing storage fees, or if they ultimately deny a claim where liability is clearly on the other party, that's when a conversation with a personal injury or insurance bad-faith attorney becomes really worth your time. Most do free consultations. The fact that you have a police report, witnesses, and contemporaneous photos puts you in a strong position — don't let them make you feel otherwise.

    • 4
      level-overpass221

      Saving this whole thread. Really appreciate the honesty here.

  • 16
    brave-wren-132

    Quick question — did you get a vehicle history report before you bought the car, or just the mechanic's inspection? Because if there was prior insurance activity on that VIN that the previous owner never disclosed, the history report would show it and actually help YOUR case here by proving the damage predates your ownership. Worth pulling one now if you haven't.