Every year, billions of dollars are lost due to people filing false insurance claims. Because that kind of loss tends to trickle downward, the rest of us pay much higher premiums.
Unfortunately, there are a lot of dishonest people in the world. They are the ones who torch their own vehicles and then insist that their cars were stolen. They set fire or hire someone to set fire to their homes and businesses. And, you guessed it, they lie about it in an effort to rake in the big bucks.
Those who commit workers compensation fraud or disability insurance fraud to collect benefits also very negatively affect the rest of us and the workforce in general. Most of the time, a person files a false claim, insisting that they were injured on the job. And of course, the injury prevents them from working.
Very frequently, the condition is something difficult to prove false, such as chronic back pain. So the person committing fraud often draws lost wages from his job. Many people involved with these types of scams secretly work a second job, too.
Some employers and their insurance carriers who suspect foul play call on to find and accumulate the facts that can right the wrong.
Depending on the case, our investigators might only need to conduct surveillance for a few days, observe the supposedly injured employee as he rides a bike or plays ball in the yard with his kids, videotape the activity and secure it as evidence that can be used in court.
Our surveillance in a workers compensation fraud investigation may show the subject using crutches and other medical devices to go into and leave doctor’s offices. Those details aren’t congruent with other activities like those mentioned above. And, sometimes, we actually collect data that shows a medical practitioner is involved in fraudulent activity. A red flag waves when we see subjects enter the offices without any pain or using any devices. Typically they only stay a few short minutes, too.
There are a few times that a workers comp fraud investigation has to get more involved, due to the careful ploy of extremely talented con artists. During some investigations, we discover if the case at hand isn’t the first fraudulent stunt pulled off by the suspect. When we secure that kind of information, we realize that our investigative efforts might have to be more involved.
On those occasions we might have to plant an undercover insurance fraud investigator at the gym where the suspect is lifting weights and running on the treadmill, even though he has reported to his employer that he is so injured, he can barely walk. Using a covert body camera, our investigators provide evidence that the employee is in fact very able-bodied.
Especially in the case of suspected long term disability fraud, our investigators might be called more than once to surveil and document activities of a claimant. It’s not unusual for a claimant to be very diligent about the rouse in the beginning, but relax after a while. So, if fraud is suspected, our insurance fraud investigators are called back in. It’s not unusual for insurance fraud investigations to be undertaken several times across a span of years.
We find and document the facts and the truth will eventually be revealed.
-Brenda McGinley, CEO, All in Investigations, All in Investigations