Hiring Private Investigators for Insurance Investigations

Hiring Private Investigators for Insurance Investigations

Hiring private investigators for insurance investigations

Private investigators have a cultural reputation for many things—surveillance, infidelity, undercover operations—the exciting things we’re used to seeing in movies and television. Many people are unaware that private investigators also take a huge piece of their corporate pie from insurance investigation. Private investigators use their unique skillsets and experiences to pursue the truth in insurance claims to establish their merit and prevent insurance fraud.

There are many ways to commit insurance fraud. For example, a homeowner might remove property from their home and then report it as stolen. They might deliberately cause damage to their property and then report a freak occurrence, or weather, as the culprit. When a suspect claim comes across a processor’s desk, they can hand it over to a private investigator to perform due-diligence and vet the claim.

Private investigators can use their famed surveillance methodology to track the homeowner to a secure location where “stolen” property is being stored. They could use their access to verified databases to look at an individual’s various histories, such as criminal, transience, and litigation. All relevant information is compiled and generated in the form of a comprehensive report in which the private investigator provides clear recommendations regarding the validity of the claim.

Sometimes insurance companies only want the private investigator to take pictures of an accident site, or an injury, or maybe they just want some spot-check surveillance on an employee claiming worker’s compensation. Another way insurance companies can rely on private investigators is with document review. Private investigators can comb repair receipts, financial records, police reports, and social media for evidence the claim is fraudulent.

Some insurance companies rely on their own internal investigators to vet and process their claims. It may be more cost-effective to keep the investigation in-house, or leadership might be more comfortable using an internal investigator. The inherent problem with any internal investigation is that any investigating agents who have a stake—direct or otherwise—in the insurance company cannot be completely objective. In an industry where litigation is not only possible, but likely, insurers and guarantors of benefits must be sure their investigations are comprehensive and will hold up to scrutiny.

A common unforeseen issue with handling insurance claim investigations internally is that it has the potential to slow down daily operations. Claims gather and bottle-neck at the choke point in the process, causing employees to feel overwhelmed and increasing their margin of error, which may result in more lost time and resources correcting those errors. One of the greatest advantages of hiring a private investigator to vet insurance claims is their valuable autonomy. They have their own databases, their own league of investigators, and their own processes. The investigations process can move quickly because there is very rarely a chain of command and little bureaucracy involved, leading to more closed claims and greater success for the company.

Contracting due-diligence out to private investigators means less stress on internal employees and another layer of credibility for the investigation. Whether as a replacement for an internal team or on a case-by-case basis, private investigators can give insurance providers the valuable information and expertise they need to close cases swiftly and effectively.

Naptown Sleuths: Being a PI in Indianapolis

Naptown Sleuths: Being a PI in Indianapolis

indianapolis indianaIndianapolis, Indiana is home to many impressive things. The city of over 800,000 is most famous throughout the country as home to the Indianapolis Motor Speedway, the site of the Indianapolis 500. In addition to a rich visual and performing arts culture, it’s also home to the nation’s largest children’s museum. Families across the United States cheer for one of two major sports franchises based in Indianapolis: the NBA’s Indiana Pacers, and the NFL’s Indianapolis Colts. It’s also home to one of the country’s best private investigators.

Family-owned and operated for more than 30 years, Lauth Investigations International has specialized in complex corporate, financial, and private investigations worldwide. It is one of many private investigation firms based in Indiana’s capital. Given recent crime data, Indianapolis is a city where a well of clientele may never run dry. One of the areas of criminal investigation most associated with private investigators is missing persons and violent crime, so it’s no a wonder why so many private investigators have set up shop in Indianapolis, with violent crime on the rise.

Relative to its size and population, Indianapolis is comparable to Portland, Oregon or Charlotte, North Carolina. Portland has a crime rate of 227 per every 100,000 people, which is lower than the national average crime rate. North Carolina experiences a higher than average crime rate of 441 per every 100,000 people. As of 2016, Indianapolis’ reported crime rate was 823.2 per every 100,000 people. A CBS News report ranking dangerous cities placed Indianapolis as the 12th in the nation, citing the violent crime rate at more than three times the national average.

News media is saturated with headlines concerning violent crimes committed against Hoosiers, so it was a surprise to most when the FBI reported crime was actually down 10% from 2016 to 2017, especially burglaries and robberies which were down 17%. Violence—especially gun violence—however, is climbing. As of October 1st, 2018, the Indianapolis Metropolitan Police Department had investigated 127 homicides and 109 murders, with 12% of those cases attributed to robbery. The recent murder of Tykece Mike-Jones is a tragic example. He was killed over a cell phone he was attempting to sell to a person he contacted through the internet—another in a string of killings IMPD has been putting on blast to warn citizens. According to the FBI, 2017 was the third record-breaking year for crime statistics in Indianapolis, and stats from the first half of this year have projected 2018 will be no different. Law enforcement attributes the overall drop in crime to the increased ubiquity of surveillance cameras in the metropolitan area.

human traffickingFirms like Lauth Investigations International can assist in many types of criminal investigation. Just as in the case of violent crimes, private investigators combine the skills of law enforcement and the autonomy of a private citizen to conduct concurrent or independent investigations into a person who vanishes under any circumstances. But not all missing persons cases are the result of a person meeting a violent end. As “the crossroads of America,” Indianapolis experiences a moderate to high level of human trafficking. One of the most complex issues in human trafficking is tracking traffickers across multiple jurisdictions as they transport victims from city to city. Law enforcement can often be handcuffed by jurisdictional issues, but private investigators use their autonomy to pole vault over this red tape in pursuit of leads that might otherwise go cold. Due to his experience in complex missing persons investigations, private investigator, Thomas Lauth has worked with Interpol, the Federal Bureau of Investigation, the U.S. State Department, the U.S. Consulate and other foreign embassies on a myriad of cases, including human trafficking.

Indianapolis private investigators are not limited to cases of violent crime and missing persons, however. Every major metropolitan area will always have cases dealing with infidelity or child custody, but private investigators based in Indianapolis have ample opportunity to service local businesses with their skill-set. Indianapolis is home to a diversified body of businesses, but its five top industries are:

  • Finance
  • Insurance
  • Real estate
  • Rental
  • Leasing

Many business owners—especially small business owners—often are not aware of how a private investigator’s services can protect, or even save, their companies. Every business needs valued employees, and finding the right person can often be an arduous task. The candidate might be qualified, but how much about their record can be independently verified? Hiring a private investigator to do background checks for employees will ensure that any verification of their qualifications will be vetted. In the wake of the #MeToo movement, many employers are making independent background checks a regular step of their hiring process in order to weed out potential predators in their workforce. All types of business can experience the full spectrum of employee theft (from vanishing office supplies to full-on embezzlement), violation of non-compete agreements, and offenses under the umbrella of employee malingering, including FMLA abuse. The independent involvement of a private investigator in the investigation of any employee misconduct will lay a strong foundation for any HR or legal consequences, ensuring that the investigation is thorough and objective from beginning to end. Kristen Justis, the Managing Director of Client Relations for Lauth Investigations International, commented on the role Lauth can play in bolstering local business, “We have a wealth of opportunities to help private citizens every day. We help frantic parents find their missing child, or put a spouse’s suspicions of infidelity at ease, but those are the cases that sensationalize this industry. Many business owners are not aware of how the services we offer can go a long way towards extending the longevity of their businesses.”

Every major industry operating in Indianapolis can rely on the services of a private investigator to protect their business—not just from its own workforce, but potential consumers as well. Finance, insurance, and real estate of all kinds can benefit from a comprehensive vetting of a consumer after their request for services. Financial institutions and insurance brokers may check a consumer’s credit, but a full background check on an applicant can sharpen the big picture when making a cost-benefit analysis regarding any transaction. In the housing industry, any landlord renting or leasing their property can be fully informed about their tenants when they employ a private investigator to run a background check. An analysis of Indianapolis’s economy by the Indianapolis Business Journal concluded that the apartment booms the city experienced were driven largely by empty-nesters and childless millennials, projecting that it would only continue to grow.

Indianapolis already has a national economical reputation for developing and sustaining niche markets, such as the market around motorsports and auto-racing. As the metropolis continues to grow in population and economy, so will the opportunities for Indy-based private investigators to support their community.

Carie McMichael is the Communications and Media Specialist for Lauth Investigations International. She regularly writes on missing person and investigation topics. For more information, please visit our website. 

Protecting Your Business from FMLA Fraud

Protecting Your Business from FMLA Fraud

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FMLA fraud can devastate a company, but companies should protect the integrity of their investigations to protect themselves.

The Family and Medical Leave Act (FMLA) provides working families balance to their lives when their circumstances take a turn. Whether it’s caring for new life in the household—such as a newborn or a foster child—or to care for an ailing relative, the 1993 act protects employees from being terminated from their jobs when they must take an extended absence for a specific set of reasons. However, abuses of FMLA are extremely common in the American workforce. While suspicions of FMLA abuse should be taken seriously by employers, companies must conduct thorough and unbiased investigations before terminating any employees. Businesses who do not follow protocol can open themselves up to expensive litigation.

In addition to protecting employees from termination during an extended leave, FMLA also requires their various insurance coverage remain in effect. This protection can be guaranteed for up to 12 weeks. According to the Department of Labor:

FMLA is designed to help employees balance their work and family responsibilities by allowing them to take reasonable unpaid leave for certain family and medical reasons. It also seeks to accommodate the legitimate interests of employers and promote equal employment opportunity for men and women.

FMLA applies to all public agencies, all public and private elementary and secondary schools, and companies with 50 or more employees. These employers must provide an eligible employee with up to 12 weeks of unpaid leave each year for any of the following reasons:

  • the birth and care of the newborn child of an employee;
  • placement with the employee of a child for adoption or foster care;
  • to care for an immediate family member (spouse, child, or parent) with a serious health condition; or
  • medical leave when the employee is unable to work because of a serious health condition.

The use of FMLA within these guidelines (with some exceptions) is designed to protect hard-working men and women from losing their jobs when their family suddenly requires their attention. Life can change so fast, and employees can rest easy knowing their jobs will be waiting for them when they are able to return in top-performing condition.

According to Charlie Plumb, an attorney who represents clients in all phases of management, abuse of this protection should be investigated, provided the employer has an “honest suspicion.” He goes on to say, “This honest suspicion standard is really intended to protect the employer against a claim they are interfering against FMLA leave and/or being retaliatory.”

A familiar scenario is one where an employee has been granted leave under FMLA for a serious illness or injury. The employer then happens to see posts from the employee on social media having fun out with friends, exercising, or driving. The employer might think, “If they’re well enough to do these things, they must be well enough to work.” While this might sound like an open and shut case from the employer’s point of view, Allen Smith of The Society of Human Resources Management, provides an example where this philosophy proved problematic:

“Joan Casciari, an attorney with Seyfarth Shaw in Chicago, said she handled a case that involved an employee who was put on FMLA leave for depression. The employer later discovered, through surveillance, she was doing Christmas shopping with her family and having a wonderful time. But her doctor confirmed “retail therapy” was consistent with her condition and the fact she could shop did not mean she did not require FMLA leave.”

Luckily for the employer in this anecdote, they did their due diligence and consulted a medical professional who could corroborate the circumstances of her FMLA qualifications. Some employers are far hastier. When employers do not conduct comprehensive and objective investigations into suspicious FMLA claims, they can open themselves up to lawsuits that can be devastatingly expensive and a public relations nightmare.

Vigilance of adherence to the guidelines of FMLA becomes manageable when Human Resource directors keep an eye out for certain patterns of behavior, such as absence patterns, especially when they coincide with non-work events (holidays or something personal that they may have mentioned in the past). Employers should also be suspicious of absences directly contradicting any medical certification in frequency or duration.

Once an employer has a reasonable suspicion of FMLA abuse, they should most certainly investigate. However, internal investigations into these kinds of abuses can be very messy for Human Resources and upper management. The aforementioned scenario involving “retail therapy” could have been a disaster if the company had not done their due diligence. Some employers are not so diligent.

Another scenario involving a maintenance worker at a nursing home and rehabilitation center panned out much differently. The employee in question noticed his superior was exhibiting a pattern of absence he found suspicious. He began reviewing surveillance footage to compare to his own personal log of her comings and goings in order to prove she was abusing company time. After discovering the independent investigation, the superior served a series of performance adjustments to the employee before terminating him. The termination came after the employee had submitted an FMLA request. The court found the dates of his termination tied in too closely with his request for FMLA, allowing the employee to take the case to trial.

Scenarios like these are why Human Resources and management should 1) be vigilant of FMLA abuse, and 2) conduct a thorough and unbiased investigation in order to ensure the company is protected from litigation. Many companies choose to handle investigations internally in order to minimize the amount of exposure. However, internal investigations spearheaded by current members of staff, will not only disrupt daily operations, but can also have negative effects like the case of the nursing home. The employee conducting his own investigation may have had honest suspicions of his superior’s misconduct, but he was certainly not a unbiased source to investigate.

Private investigators are probative routes often overlooked when a company has an internal investigation. There are many circumstances under which companies do not want to give up control over an internal investigation, and a private investigator is the definition of a third-party. However, the objectivity of a private investigator is the number one reason why companies should consider them as an option. The personal biases of the persons involved in the previous examples caused the investigation to go south. As an independent contractor, a private investigator’s only loyalty is to the truth. They are vital to ensuring an investigation is a transparent expedition for the truth. This goes a long way towards protecting a business from subsequent lawsuits or bad press.

When handling an investigation internally, employers are limited to what surveillance they can attain from their own equipment or social media. Private investigators are licensed to track individuals and photograph their activity in public. Persons who fraudulently claim to be out for injury can be photographed doing tasks directly contradicting their FMLA claim, like yardwork or lifting heavy groceries. In addition to tracking their public movements, private investigators may also conduct undercover operations in order to investigate any frauds. They are invaluable in this regard as they are not known to those within the company. Whether you’re looking for an FMLA weekender or an FMLA moonlighter, if someone has made a fraudulent FMLA claim, a private investigator is the most-equipped professional to prove or disprove the suspicion.

DENISE WILLIAMS INDICTED FOR MURDER

DENISE WILLIAMS INDICTED FOR MURDER

In the weeks following the capture of the infamous Golden State Killer, in which the survivors of the victims were finally given some closure, the family of a missing Florida man may finally have some answers as well after seventeen years of silence. Denise Williams, 48, was arrested on May 8th, 2018 for the first-degree murder of her first husband, Mike Williams. Her ex-husband, Brian Winchester, who is currently serving time for kidnapping her at gunpoint in 2016, was also identified in the court documents released on Tuesday as the person who shot his best friend, Mike Williams, on December 16th, 2000. The murder came just six months after Winchester had sold Williams a one-million-dollar life insurance policy, which his wife was able to collect, despite the fact his remains would not be found for seventeen long years.

In an astonishing coincidence, WCTV Eyewitness News in Tallahassee was able to locate archived footage from the year 1999, in which both Denise and Mike Williams appeared in a segment in early May as part of Mother’s Day. Their daughter was born in said year on the eve of Mother’s Day, prompting the media outlet to cover the new family as a human-interest story. In the footage, Mike Williams expresses how much more respect he has for his wife and women in general for their ability to bring a child into the world. This eerie footage is now being re-examined, with investigators and armchair detectives alike, wondering how this picturesque nuclear family unraveled in a story of greed, betrayal, and murder.

Investigators postulate Denise Williams and Brian Winchester started conspiring to kill Mike Williams less than a year after the human-interest piece aired on WCTV in Tallahassee. Six months before the fateful duck-hunting trip, Winchester sold Williams a life insurance policy in the sum of $1 million dollars, a decision raising no eyebrows at the time. Williams had a wife and 18-month-old daughter who would need caring for if something were to happen to him, so he purchased the policy.

When Williams did not return from his duck hunting trip on December 16th, the authorities were called. When the police found Williams’ abandoned boat on the water, the investigation tapered off after the theory was floated he was eaten by alligators. Despite dragging Lake Seminole, police were not able to recover a single trace of Mike Williams’ remains.

From the jump, there were people who did not believe the story police had given as an explanation for Williams’ disappearance, most significantly his mother, Cheryl Williams. In 2016, Cheryl Williams told The Daily News she did not believe her son was the victim of an alligator attack, but rather the victim of a black widow. She told her story to the media outlet as part of the coverage of Brian Winchester’s 2016 kidnapping and holding Denise Williams at gunpoint. It was her assertion from the beginning, she said, her daughter-in-law was involved, “I lost my son, his daughter lost her father and Denise is the only one who got millions of dollars,” Cheryl Williams said. “She and Brian are the only ones who profited from his death.”

The theory of Mike’s death, in which he’d been eaten by alligators, left a loophole allowing Denise Williams to collect on her husband’s insurance policy despite the fact authorities never recovered a body. A complete search of the lake left law enforcement and Mike’s mother without answers. In an additional tragedy to losing her son, Cheryl has also lost contact with her granddaughter, whom Denise Williams has barred Cheryl from visiting for the past ten years after Cheryl convinced law enforcement to open an investigation. These devastating losses were what propelled her to go to the police with her suspicions. Cheryl was finally able to persuade law enforcement to open an investigation into her daughter-in-law, but only for insurance fraud. It was a start, Cheryl told the media, and ever since, she has been championing for those responsible for her son’s disappearance to be brought to justice.

Five years after her husband went missing, Denise Williams married Brian Winchester. The couple separated in 2012, which sparked a series of domestic incidents ultimately culminated in Williams filing for divorce in 2015. The ongoing investigation into Mike Williams’ death left law enforcement with little recourse other than to turn up the heat on Brian Winchester.

According to the Tallahassee Democrat, friends reported Brian Winchester was acting strange around the time of the kidnapping, “In an interview with investigators, anesthesiologist Dr. Stephen Mnookin said he went to lunch with Brian Winchester hours after the Aug. 5, 2016 incident involving Denise Merrell Williams…At Village Pizza off Thomasville Road, Mnookin said a nervous Winchester told him the police were “after him” and kept contacting him, warning once their divorce was final, “his wife is going to say something about this guy who died 10 or 12 or 15 years ago.” The increased pressure on Winchester as a suspect, the news of his mother’s terminal cancer, and rejection from his son, who wanted to live with his mother, Winchester’s first wife, allegedly triggered his ex-wife’s kidnapping. On August 5, 2016, Winchester snuck into his ex-wife’s car and laid in wait for her to return. When she did, he held a loaded gun against her ribs for almost an hour. He was sentenced to 20 years in prison in 2017.

Now with Winchester behind bars, negotiating with law enforcement, it seems investigators might finally be closing in on the truth behind Mike Williams’ cold case. In late December of 2017, Mike Williams’ remains were finally found—not in Lake Seminole where he allegedly drowned and was devoured by alligators—but in northern Leon County. Armed with this new evidence, the state was finally able to secure an indictment against Denise Williams. She was arrested on May 8, 2018 at her office at Florida State University. She is officially charged with first-degree murder, conspiracy to commit first-degree murder and accessory after the fact. Presentation of the state’s case to a grand jury resulted in jurors naming Williams as the mastermind of the insidious plot to have her husband murdered for the insurance money. Ethan Way, Williams’ attorney, addressed the public about the innocence of his client in court, “My client had absolutely nothing to do with Mike Williams’ disappearance and had absolutely nothing to do with any of the crimes that Brian Winchester committed. We will fight this until the end.” Judge Nina Ashenafi Richardson of Leon County denied Williams’ request for bail, resolving to detain her in the Leon County Detention Center. Ethan Way has filed a motion seeking bail to be heard at an impending court date later in May.