Auto Insurance Claims: insurance adjustment after car accident (for novelist), special investigative unit, insurance adjustment


Question
I need to understand how an insurance adjuster would handle a fictional car accident that at first seems accidental, but later shows signs of being deliberate.
(Will require some detail and back and forth.)

Answer
The adjuster would start by taking recorded statements from all parties, including drivers, passengers, and witnesses.  Both vehicles would be inspected and estimates written by a company appraiser.  Photos would be taken of the vehicle.  If there was a dispute, the adjuster would likely visit the scene, do a diagram, and take photos.  The adjuster would apply the facts to the law and then determine which driver was at fault, or if both were, and possibly assign percentages of liability.  If there were injuries, the person might get an attorney or they could settle with the adjuster directly.

If the loss appeared suspicious at any time, the claim would be referred to a company investigator who works for the special investigative unit, aka SIU.  The investigator would run background checks on all parties.  He/she would likely conduct lengthy in person interviews in which multiple details are reviewed.  The investigator would look for discrepancies, both within an interview, and compared to other interviews.  The policy also allows for the company to conduct an Examination Under Oath with their insured.  They can request from from a claimant, but the claimant does not have to agree.

This is just the beginning, but this could become far more involved and go on for months or years.