slip and fall fraud Archives - All in Investigations

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 [...]

What is Insurance Fraud?

What do you think of when you hear the words, insurance fraud? At , we don’t have one description in particular because not only is every case we work on different, but insurance fraud encompasses many different situations. I thought we might take this opportunity to share some of them with you. Workers compensation fraud (WC) – This is over and above a claim for medical expenses. Claimants file claims alleging a disability that prevents them from working as they did previously. It can be a short-term or long-term claim, or even off and on. Workers compensation fraud investigations saves consumers millions of dollars every year. Long term disability fraud (LTD) – This has to do with an insurance policy. Someone buys a policy and [...]

Investigator’s Collection of Data Leads to Confession of Insurance Fraud

When the economy takes a dive or unemployment is high, the incidence of insurance fraud tends to increase as well. It’s not just greed that compels policy holders to commit insurance fraud, it is also desperation. And that is not limited to disability insurance fraud or slip and fall accidents. For example, insurance fraud investigators had a case where a car had caught fire and burned. It was a total loss. Because of a recent change to the policy coverage, a red flag went up to the adjuster and that’s why our investigator was called in. After investigating the claimant, it was uncovered that he had recently lost his job and had taken a lower-paying position with another company. Not too long after that happened, [...]

Insurance Fraud Stacks Deception on Top of Desperation

There are so many different aspects to insurance fraud. Besides fraudulent claims and falsely-acquired settlements, money may be a motivator for other types of insurance fraud. Take, for example the case of a man who lost his job. He had a wife and three children and suddenly found it impossible to find employment. He was desperate so he faked a slip and fall accident at the local mall. He claimed his slip and fall injuries were significant enough to prevent him from working and because it is difficult to prove or disprove soft tissue injuries, the insurance company was reluctant to settle quickly. His situation grew direr because now he was unable to even look for a job because it would show he was faking [...]

Slips and Fall Accidents, Fraud and Videotape

Everyone has heard of these cases, we have seen lots of them here at : the ones where a person (the claimant) has slipped or fallen and claims to have injured themselves in a restaurant or store. What you might not know is that there is a huge contingent of repeat claimants. One of the first things an insurance company does when it receives a claim is to run the claimant through an industry database of all insurance claims filed. Only people in the insurance industry have access to that database and when a person comes up as a repeat or a serial claimant that throws up a huge red flag. Many insurance companies and companies who are self-insured have special investigative units (SIUs), but [...]