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Tips for Adjusters: Get the Most Out of Surveillance Videos
The key to surveillance videos is to aid the process of disproving fraudulent claims, or rightfully payout the deserving. These tips will help the adjuster make the appropriate decision.
Consistency: Surveillance will not guarantee a benefit to the adjuster, but it will allow you to see if the claimant is legitimately injured. The inconsistency of a claimant’s behavior, such as walking with a cane at the doctor’s office, but appearing to not need it at the grocery store while carrying six bags, is an observable red flag. An extreme example, but it has happened. Numerous days of surveillance is the best way to catch the discrepancy but be sure to look for subtle differences, as well.
- Canes/Crutches: Look for proper use. Are they carrying the equipment but not necessarily using it? Do they make use of it in front of a physician, but disregard it when they leave the office?
- Medical Limitations: After acquiring the information from the physician about the claimant’s limitations, pay close attention to whether or not the claimant is exceeding them. If the “injured” is prescribed to stay off of their feet for a distinct amount of time, and surveillance video shows them jogging before the allotted time is up, there may be significant evidence to deny the claim.
- Previous Claims: Previously filed worker’s compensation or automobile claims is another huge, red flag. If research on the claimant proves him/her as a repeat offender, surveillance would be the most effective method.
Ultimately, the key is to prove regularity in the claimant’s behavior. If they are repeatedly participating in activities in which they are supposed to stay away from, chances are the claim is fraudulent and video surveillance is the perfect means to attest it.
Information obtained from: Work Comp Roundup Website & Blog
The Feds Use Video Surveillance, Too
Like ICU Investigations, the feds use video surveillance to keep track of worker’s compensation claims. For example, surveillance was conducted on two North Carolina postal workers that were collecting compensation for work-related injuries. They conveniently were married to each other, as well. According to Jim McElhatton of the Washington Times, video surveillance helped the Postal Service save more than $1 million.
Surveillance is one of the most effective and covert tactics used to collect evidence of insurance fraud. ICU Investigations uses highly trained, private investigation specialists to locate and collect relevant verification of a claimant’s every day life while in their comfort zone, when they feel that no one is watching.
The long-term use of surveillance will guarantee the results you are looking for and save you thousands, even millions of dollars in undeserved payouts.
Facebook Deemed a Valuable Tool in Catching Insurance Fraud
In an article by Ben Present of The Legal Intelligencer, Present makes the argument that posting on Facebook can be a valuable and useful tool to use for fraud investigations.
According to the article, courts are deciding that the information that someone posts on Facebook that may challenge what is being alleged can be used against them; and for good reason.
Relating this information to the insurance world is surprisingly simple. For instance, a claimant is declaring that they injured themselves at work and are collecting compensation for doing so. ICU Investigations will conduct an Internet Profile Report, making sure to cautiously scan proper social media sites for pertinent information regarding the claimant’s activities, whereabouts, photographs, etc. Any information that can be obtained that may contradict the claim will be provided to allow the requester to make a clear, more concise decision.
Also, according to Present, if the case makes it to court, the pertinent information is allowed to be accessible in testimony.
The Perfect Storm
ICU is gearing up for the “Perfect Storm” this season. November, December, January, are opportune months for surveillance on your claimants. With the Holiday season fast approaching, it has been our experience over the last 22years of insurance claims investigations that claimants are extremely active this time of the year. Whether its Holiday Shopping on Black Friday, Raking, Hanging up their outside Christmas lights and Holiday decorations, Plowing and Shoveling snow, Attending, Parties and Parades, Driving and Traveling to visit Family and Friends.
Even working under the table to pick up some extra cash this time of the year.
CLAIMANTS ARE ACTIVE THIS TIME OF THE YEAR!
Internet Profile Update
On November 19, 2010 the social networking site MySpace has signed an agreement with Facebook allowing users to sign into MySpace using their Facebook account information. Users will also be able to sync MySpace and Facebook status updates and photographs.
This new information brings new opportunities to us as insurance claims investigators, with over 500 Million members on Facebook and MySpace. This merger will allow investigators to gain valuable insight on claimants who post their daily activities and lifestyle on these sites. However there are new challenges we are faced with as investigators as this merger will also inhibit the investigation process due to users increasing their privacy settings.
We at ICU Investigations stay on top of the latest technology and techniques to provide our clients with the best internet research investigators available.
HAVE A SUSPICIOUS CLAIM? Try our IPR Report…its amazing what you will find on the internet!
Why order an IPR? Internet Profile Report This comprehensive report allows you, the adjuster, to use your valuable time to focus on handling the claim while the ICU Investigations Internet research department provides you with a detailed, at-a-glance report of your claimant’s internet profile. This could be beneficial, even essential, to your claims handling. By employing ICU to provide this service, you eliminate the risk of corrupting your corporate computer network by allowing us to use our secure database servers and Internet profiles to research and find claimant information on your behalf. There are more than 300 known social networking sites on the Internet. Myspace.com has more than 185 million users and Facebook.com adds 20,000 new users each day. Too often, investigators overlook or underutilize this valuable resource. Social networking sites are virtual communities. Research investigators at ICU understand these communities, along with the tools and techniques to track a claimant’s actions on the Internet and in real life.
JUST ANOTHER ADDED VALUE BROUGHT TO YOU BY ICU…
Surveillance Specialists
ICU investigators are top notch surveillance specialists. They know how to shoot video in a way that gets documented proof of what you are looking for. From big insurance cases to individual cases of infidelity, we can help and get you the video evidence you need. We use only high end equipment and have the ability to have video ready for you overnight. Contact us today!