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.
Private investigators do a variety of work for a wide array of clients. P.I.s are best known for their work finding missing people, but that’s a very small slice of what they do. Investigators routinely help businesses with internal investigations and support human resources departments during the hiring process. It’s common for attorneys to call private investigators to assist in research and help identifying witnesses and assets to strengthen their cases.
1. Everyday Citizens
Shelia Wysocki’s roommate was raped and murdered in 1984. Two decades later the case was unsolved and had gone cold. Wysocki hadn’t given up on though and spent four years making more than 700 phone calls and was able to provide detectives with enough evidence that they reopened the case. In 2010, after all of Wysocki’s work, a jury convicted her roommate’s killer in under an hour. A dedicated investigator can shine new light on old cases and help reinvigorate an investigation.
Have you had a family member go missing? Whether it was a runaway, kidnapping, or a family member moving, private investigators can help. P.I.s have a long history of finding missing people and it’s one of the skills they’re most known for. Don’t sit around wondering what happened to them, hire a P.I. to find out and give yourself peace of mind.
If your car or home is broken into and valuable items are stolen, the odds that police will recover your belongings are low. Resource constraints mean the police are likely to push your case to the bottom of the pile. Private investigators are available even when the police aren’t and can help prevent family heirlooms from being lost forever.
2. Attorneys
Every attorney should have a private investigator’s business card in their pocket. Private investigators are keen researchers and can help make sure every lawyer has all of the relevant information for every one of their cases. Contracting a third party to handle research can also lower costs for clients since the hours won’t be billed to the attorney, increasing the value client’s receive.
Private investigators can strengthen cases by identifying more witnesses and evaluating the witnesses you already have. Are you having trouble contacting someone you need to interview or depose? Private investigators can help you make the contacts you need and ensure they’re up for the tasks ahead.
3. Business Owners
Businesses and corporations stand to gain a ton by employing the skills of a private investigator. Save time and money by having a P.I. handle background checks and vetting of potential new hires. Bring the right people onto your team the first time and dedicate resources to other ventures.
Need to do an internal investigation, but worried about intraoffice relationships making it difficult? Do you suspect there may be drug use or theft happening on your property? P.I.s can conduct discreet internal investigations that will produce objective results quickly.
4. Insurance Agents
Every insurance agency should have a strong working relationship with private investigators and the reasons why will strike most people as obvious. When someone files a claim for injuries or disability, how can you be sure it’s not fraudulent? Estimates say insurance payouts are between $80 and $120 billion a year. 10% or $8 to $12 billion of those claims are projected to be fraudulent.
Pretending to be hurt during an interview is easy, but how many people can stick to their act 24 hours a day, seven days a week? Take the case of a young man who, after losing the tip of his finger, claimed he couldn’t lift his right hand and that touching it caused excruciating pain. A private investigation firm was able to disprove these claims and save millions of dollars by scouring the man’s social media and finding pictures of him playing instruments and going down water slides. Protect yourself from fraud by hiring a private investigator.
For Private Investigation Inquiry contact Thomas Lauth, Lauth Investigations 317-951-1100
David Schroeder, Blog Writer, Lauth Investigations International
Melbourne, April 26 (ANI): Social networking sites like Facebook are being used by private investigators to uncover false claims made to insurance companies.
International experts have revealed that the sites are ‘gold’ for identity thieves, reports Courier Mail.
They are perusing photos and comments made on the sites of claimants and witnesses to see if they tally with statements made to insurance companies.
In some cases investigators are uncovering photos showing people who claim to have injuries preventing them from working doing activities such as skiing.
But sites such as Facebook also have become a tool for investigators to uncover people doing undeclared jobs, to track down those who owe debts and uncover the shady past of job applicants.
Investigation firm MPOL Investigations Australia has an agent dedicated to searching the social networking sites.
Using a social networking site, the company discovered that a claimant who was suspected of having undeclared income did have a hidden part-time job.
While the Facebook site had a privacy block, the investigators were able to search an open “friend” site, which provided a clear link to their subject.
The investigation firm used photos on a social networking site to prove that people who claimed their home had been broken into were at home at the time, having a party.
Julia Robson, the company’s social networking specialist, said one person claiming to have a foot injury posted family pictures showing him playing soccer.
Craig Adams of Brisbane’s CA Investigations said information gleaned from social networking sites mostly was used to gauge how much people exaggerated their claims.
He said in one case a woman who claimed she had a psychological injury and could not socialise, posted Facebook photos of herself sitting in bars on Melbourne Cup Day. (ANI)
