Arson and Insurance Fraud

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I have an anti-hero who owns a bar. His enemies blow the bar up.

The police are looking for ways to arrest my anti-hero and think he burned his own bar down as insurance fraud.

The fire WAS arson. But it wasn't by my anti-hero. But he was connected to the arsonists, at least through mutual enmity.

If my anti-hero makes an insurance claim, would the payout be held pending a criminal investigation? If the investigation was inconclusive, would the insurance be paid, or would it at that point shift to a civil standard of proof, whereby my anti-hero would be more likely than not to be committing insurance fraud, and therefore not get any money?

(I don't really care what the outcome is. The arson stuff is a red herring in my story, so I can make it fit no matter what. I just want it to sound realistic).

Thanks for any insight!
 

jclarkdawe

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Blowing up the bar is not arson, and tends to be a lot easier to determine. Blowing up anything brings in the Federal mix of alphabet agencies. Arson tends to be a local crime, investigated by the locals.

Payout would be held pending completion of the police investigation. This could be anywhere from a month to years. If the police report indicated your guy was a suspect, payout would be delayed even longer. Probably your guy would have to file in civil court to force a payout.

We're talking years. Ten years would not surprise me and has been exceeded in these types of situations. Appeals are very common if the insurance company loses. If the insurance investigator suspects fraud, they can be very creative in stalling.

Best of luck,

Jim Clark-Dawe
 

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Good info - thanks!

Is there a more precise definition of the difference between arson and 'blowing up'? I was thinking that there would be an initial explosion followed by fire, so... arson. But if the initial explosion is big enough, it becomes federal? What crime would they be investigating? (like, what's the legal term, so I can do a search and learn about the distinction).

It's arson if it's purely fire. If there's explosives used, it's....

(Thanks again for the original info.)
 

jclarkdawe

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A fire that uses an accelerant to start the fire will produce a flash, but not quite an explosion. If you like risky, try dropping a match into some gasoline. Very sudden flash, but unless it is confined, it won't be an explosion. Charcoal lighter is a more controlled flash.

If you confine your accelerant in a container, the pressure in that container will increase until it suddenly hits the strength limitation of the container and you'll have an explosion. Take a can of flammable material like insecticide and heat it. You'll get an explosion when the can blows up.

IF YOU TRY ANY OF THIS AT HOME, STAND VERY FAR AWAY!!!

Fires, on their own, can flash over, where you have an explosive like event, but it is not an explosion.

Explosions and flash fires produce markedly different signatures. Among other things in an explosion is a shrapnel effect, in which parts of the container imbed themselves into surrounding surfaces.

Explosives are under the jurisdiction of the ATF and thus Federal. The line can blur towards the center, but usually it's pretty clear which is which.

Best of luck,

Jim Clark-Dawe
 

Tippecanoe1841

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I am an insurance claims adjuster. While the insurance company will closely follow the criminal investigation, they will do their own investigation including hiring their own experts, and will make their own determination on whether to pay or deny the claim. Insurance companies are bound by Unfair Claims Practices laws to do a prompt and fair investigation. If they deny the claim, they will likely be sued for both coverage and for bad faith. They must make their coverage decision based on facts and not merely on suspicion. However, it can drag out for years in litigation. I hope this helps.
 

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Very helpful! Thanks!

Can you give me a rough idea of what 'prompt' would mean? Weeks, months, years?