Insurance Fraud Surveillance
Insurance fraud costs are generally estimated in the billions of dollars annually. Fraud can range in severity from outright intent to defraud the insured to cases of malingering or exaggeration. We specialize in surveillance related to the insurance industry with particular emphasis on Worker’s Compensation Fraud, Disability Fraud, Liability, and Unemployment. While we also conduct excellent SIU investigations. The majority of our caseload consists of surveillance for insurance companies. Most importantly, we get results.
There are many easily identifiable red flags associated with the various types of insurance fraud. For Worker’s Compensation and Disability Fraud, red flags can include, but are not limited to: being unable to reach the claimant at certain times of the day, hearing “work related” noises in the background during phone conversations, compounding injury exacerbations, adding injuries unrelated to the original injury, minor injuries evolving into major injuries, overall unexplained health decline, restrictions do not match original injury, doctor shopping, neighbors or co-workers reporting suspicious behavior, statements made by claimant in the weeks preceding the date of loss, etc. For SIU investigations, red flags can vary greatly regarding the incident in question. For “slip and falls” or “trip and falls”, a lengthy civil history can shed light on a litigious individual. Also, circumstances surrounding the incident can provide red flags, which include unwitnessed accidents, a hazard occurring in an area not known for hazards, surveillance footage contradicting incident, immediate attorney representation, immediate demand for an incident report, etc. For automobile accidents, securing statements generally provide insight. Additionally, scene photographs supplement the facts provided in those statements to include points of impact, damage locations, skid marks, assessment of traffic control devices, etc.
Instances of malingering or exaggeration comprise the majority of claims and is referred to as “soft fraud”, however, “hard fraud” has been on the steady incline. Generally speaking, when job security and employment rate decrease, there is a corresponding increase in the amount of fraud related cases. While most cases can be categorized as malingering, outright fraud . Without a doubt, fraud can substantially impact the bottom line of any company. We combat fraud and take pride in our work.
Our clients rely on results and we understand that. Unlike many of our competitors, we will not take your case and subcontract it to an inexperienced investigator or have it handled by an inexperienced employee.
Our investigators are individually state licensed. In most states, being an employee of a state licensee is not the same as being individually licensed. Most employees or subcontractors working off of the license of a state licensee are very inexperienced, lack the tools necessary to secure proper documentation, are overly timid or overly aggressive in the field. Any one of these could negatively impact your investigation.