insurance fraud investigations Archives

Insurance Fraud is More Common Than You May Think

There are many kinds of insurance that individuals need to be covered for every event in life. And here at , we do conduct the following: Personal Injury Investigations, slip and fall accident investigation, product liability cases, vehicle accident investigations, worker’s compensation fraud investigation and disability insurance fraud investigations and many times just fraud investigations. We received a call from an insurance company that they had a claimant who filed a claim that his house had been broken into and his audio equipment had been stolen. He estimated the worth to be around $35,000.00. He had called the police and made a report and was given a police report. In the report there were a few statements that just didn’t make sense to the Insurance [...]

Insurance Fraud Exposed in Surveillance Recordings

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 [...]

Who’s the Fraudster in Insurance Fraud?

Insurance fraud is a huge problem and insurance companies have gotten a reputation for being hard to work with on insurance claims. They see a lot of fraud and the red flags that pop up are taken very seriously. is called in by insurance companies when they see red flags. We don’t make decisions on cases. Our job is to find facts. Sometimes the facts just keep compounding. In one workers compensation fraud investigation, we were asked to surveil a claimant to determine if the patient was really disabled. Workers comp fraud is everywhere and the premiums are very expensive, in part because of the amount of fraud. Workers compensation investigation can include documenting the claimant’s activity as well as their contact with medical providers. [...]

Private Investigators Play Big Role in Detecting Workers Compensation Fraud

As professional investigators, we provide each of our clients with only the best combination of skill sets. Very proudly, we can boast that our investigators are long-time leaders in the areas of digital forensics including both forensic computer analysis and mobile phone forensics. In fact, our lab is one of only a few private, full-service forensics labs in the nation. But along with our dedication to mastering all of the newest technology, we also pay close attention to social issues and criminal activities which, unfortunately, continue to thrive. One of the fastest growing schemes is fraudulent claims filed for workers compensation benefits. In fact, in the most recent studies of this form of fraud, more than 45,000 active cases were active, involving employees pretending that [...]

Intuition Speaks Loud and Clear When You Need an Investigator

The staff at would like to remind you of a couple of old sayings. Both are about intuition. One of the sayings goes something like, “If you wonder if you can trust a person, you already know you can't” and the other is, “If it feels wrong, it usually is.” There are countless ways these sayings can apply to your career. If you are an insurance provider and your client tells you that his house just suddenly burned to the ground, you might get the feeling that your client is being dishonest and you have uncovered a case of insurance fraud. There may be red flags that pop up as you discuss the incident like the house being empty while they were away for a [...]

Surveillance Equipment Documents Workers Compensation Fraud

Like nearly every other business owner he knew, Lance paid close attention to the bottom line. He felt responsible for employees working in his chain of convenience stores. Many of those employees had been with Lance for more than a decade. In fact, Lance believed his stores were surviving the economic crunch because employees were friendly and fair to customers, just as Lance was friendly and fair to workers. That was exactly why Lance was upset about a workman's compensation claim filed two months ago by a new employee. According to the claim, the employee injured his back and neck when he slipped and fell on a freshly mopped floor. Other employees told Lance the wet area was marked with a cone and no one [...]

Hurrying Through Hiring and Skipping Background Investigation Has Consequences

Years ago, Bill learned his lesson, which is the fact that you just can't take anything at face value, especially people. Like all of those lessons that last a lifetime, Bill learned this information the hard way. It happened when he hired two new employees for the city courts system. There had not been enough time to adequately complete the HR due diligence checklist including background investigations, as Bill and his staff would normally do with new hires. At the time, the offices for the heavily populated city were grossly understaffed. The employees were all stressed out and overworked. All anybody wanted, at that time, were a couple of warm bodies to sit in front of the telephones and computers. As luck would have it, [...]

Is it Stress or Is It Insurance Fraud?

By the time Hal met with , he looked downright exhausted, not to mention angry. Nothing in life had been easy since the situation at his company had spun out of control. By the way, “the situation” involved Hal's very successful real estate company and Gwen, his very difficult employee. Gwen was hired to be an administrative assistant after Hal explained that the role could be busy and stressful. Gwen had assured her new employer that she could very confidently complete all of the tasks. Hal was so impressed with Gwen that he did not follow through with the routine background investigation. Five months after Gwen's probationary period ended, she began to frequently call in sick. Her absences gradually increased to once or even twice [...]

Insurance Fraud Covers More Than a Falsified Slip and Fall Claim

We have all heard the horror stories about employees who scam the system and cost their employer lots of money by filing false claims and committing workers compensation fraud. But another very real issue involves dishonest business owners who scam coverage providers. And so, when insurance companies contact about insurance fraud, we move swiftly to resolve the problems. Because, for every day that a dishonest business owner gets away with this crime, everyone else is at risk, whether we're talking about financial loss for the insurance carrier or benefit loss for innocent employees. Crooked business owners illegally reduce the owed amounts of workman's compensation premiums by hiding behind fake companies. This practice can be difficult to discover since the business may even provide bogus accounting [...]

Business Owners, Insurance Companies and Private Investigators Work Together to Eliminate Insurance Fraud

As our clients know, earned our excellent reputation because we are results oriented. Definitely, we think outside the box, approaching every case with a willingness to use whatever skills and resources necessary to gather evidence. Even the best of scam operators can't slide past our investigative tools since those tools and research skills are also mixed with persistence and the highest level of confidentiality. These facts about our agency bring insurance companies to our door. Recently a claims agent called because one of the business owners the company insures came to them with some concerns. He was certain that at least one of his employees was fraudulently collecting workers compensation benefits. But he had recently heard gossip about a second employee who was also drawing [...]