private insurance fraud investigators Archives

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 [...]

Don’t Become a Victim of Vehicle Accident Insurance Fraud

It was reported at Bankrate.com that fraud is an element in one out of every 3 auto insurance claims in New York City! That is incredible and officials say that this fraud adds an estimated $241 million to premiums every year. New York City is not alone. The article reported that the top five states for auto insurance fraud are California, Florida, Texas, New York and Maryland. Is it no wonder that insurance company claims adjusters are always looking for red flags? When there is something that makes the adjuster question the legitimacy of a claim, they often call an investigator in on the case. A vehicle accident investigation can result in determining one of the following staged crashes has occurred: Wave down: requires two [...]

Car Arson – Insurance Fraud or Criminal Case? Could be Both

You would think calls to regarding car arson would be from an insurance company representative saying that arson was expected regarding a claim. But experienced investigators never jump to a conclusion – they listen to the whole story before moving forward. And since investigates so many different cases, they know there are many directions a call can go. This particular story began with the attorney representing the accused. Sure enough, the insurance company wanted to deny a claim because of arson and the municipal police investigating were supporting the District Attorney’s decision to prosecute the car owner for arson – with insurance fraud charges on top of that. There was no need to be concerned about getting the accused man’s cell phone, he was happy [...]

Insurance Fraud Investigations Also Uncover Forgery

In the course of insurance fraud investigation, Internal Investigators has uncovered a trend that accompanies some claims – and that is forgery. Product liability cases can involve anything from a vehicle, to a food product, furniture, building materials and everything in between. When a claim is made about a product that might require relocating or acquiring rental cars, campers or the like, fraud and forgery can go hand-in-hand. Case in point is a pending case in New England. A man has been charged with insurance fraud and forgery in connection with a claim made to his insurance company. There was a problem with his vehicle and he said it could not be driven. He submitted more than $500 worth of receipts for a rental vehicle. [...]

Slip and Fall Accident Investigation – We Do It All!

One of the purposes of the blog is to educate our customers and clients – and prospective clients. We do that by staying abreast of news and sharing that and insights with you. Therefore, when we discovered that many insurance companies and underwriting associations are educating their members in ways to detect fraud, we wanted to share that with you. It’s not uncommon to find a slip and fall injury case study outlining specifics of a case in an article in members’ publications or in reports online. The articles are very clear about the elements that are “of concern.” When we undertake insurance fraud investigations, we often are confronted with the attitude that fraudulent claims are really no big deal – after all, it’s payback [...]

Medical Service Providers Caught in Insurance Fraud Investigation

If you want to understand why insurance companies hire private insurance fraud investigators, consider this quote from the NorthJersey.com, the online home of The Record: "Three former chiropractors from Bergen and Passaic counties were sentenced to five years of probation Monday for setting up a fraudulent practice in Paterson and cheating more than 30 insurance companies out of what prosecutors say was millions.” Yes, you read that correctly – MILLIONS! The three medical services providers received sentences and were ordered to pay a total of $250,000 in restitution. But they cost the insurance companies millions of dollars, in fact it is reported that the three generated $2.8 million in fraudulent billings. When is called into a case like this, we know that it often results [...]