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Consider the following hypothetical: An insured submits a claim for a fire under a homeowner's policy. The fire department extinguished the fire relatively quickly and there was little damage. The insured submits a claim for the loss and, as the investigation develops, the claim triggers certain indicators that require additional information and further investigation.
The insured was the last to leave the home; the home was secure and no one else has a key. The insured's whereabouts at the time of the fire are unclear. He initially claims he was out of town on a camping trip with his kids that night, then later admits it was a school night and his wife had the children. He now states he does not remember exactly what he was doing or where he was that night. More information comes in and more issues develop. It is a new policy, and the insured filed bankruptcy earlier this year but claims it was a minor misunderstanding.
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