How many times do people have to be warned? Social media platforms are designed to share media and information socially. This means the content you post is published for social consumption. It’s why everyone’s been told to check their privacy settings carefully.
Perhaps most importantly, it’s why you think before you post.
A Brief Recap of Social Media Investigations
Social media investigations began as a bit of a novelty for insurance adjusters and private investigators. It was a welcome tool, but proving claim fraud meant hiding in the bushes, tailing suspects, and capturing video. This is not to say that these methods are no longer used or useful; they remain one of the most effective. Examining a fraudulent claimant’s social media accounts, however, ceased being a novelty in recent years, and today, it’s one of the most used, and profitable, tools in an investigator’s arsenal.
When trained investigators dive into a claimant’s social networks, e.g. LinkedIn, Facebook, Twitter, etc., they sift through personal information looking for anything that aids their investigation. Often-times, they’re looking for court-admissible evidence, information that has the potential to cease fraudulent behavior and/or terminate a claim, but social media investigations serve another purpose: gathering raw data.
Investigators record everything available, searching for names, addresses, personal connections, everything useful to verify insurance claims, including witnesses, claimant identification, claimant activity, evidence of disability, appropriateness of medical care, etc. These investigations often validate an insurance companies “red flags,” and lead to further case examination.
This activity might take the form of the following:
Gathering the basic facts
Providing photographs of the claimant
Identifying witnesses
Identifying other stakeholders in the claim
Identifying red flag indicators of potential fraud
Securing Web addresses, emails, and other Internet-based information that may assist the SIU
Gathering other facts that may help narrow social media investigation
This “validation” is what adjusters, claim handlers, and private investigators use to recommend more throughout examinations. Thus, even the most cursory investigation of social media accounts can lead to field investigations or a more in-depth dive into a claimant’s online activity.
It’s all part of a social media investigative toolkit, and these advances often aid in resolving fraudulent claims, more so than ever before.
The system isn’t perfect, though, and its abuse reinforces the popular narrative where stingy insurance companies use any excuse to reject legitimate claims. According to Diane Brown of the Arizona Public Interest Research Group (PIRG),
“Social media often doesn’t tell the whole story of an injury to the person or to their home or a vehicle. An individual may post something today that is from three weeks ago. They may post something that a physician has encouraged them to do such as to go to the gym or to go swimming.”
Brown added that social media investigations should be used cautiously, stating, “Insurance companies should follow the standard protocol of reviewing documentations that come from a physician, from a police department or some other trusted authorized entity.”
As a consumer, Brown explained, individuals have the right to ask if their insurance company is using their social media as a reason to deny their claim.
She also strongly recommended all consumers, wait for it, be careful of what they post.
Five Cases Where Social Media Doomed Fraudsters
We’ll examine cases where an individual was wrongfully denied a claim through social media posts in the near future. The following five examples, however, deserved their fate.
The Weightlifter
Jason Dross was receiving non-working wage loss, which is payable to injured workers who are unable to find suitable employment. He claimed he was looking for work but was having difficulties because he could not find a job that would not require him to lift more than 10 pounds.
The Ohio Bureau of Workers’ Compensation (BWC) decided Dross’ public photographs on Facebook were enough to justify field investigations and captured undercover video of him engaged in heavy weightlifting at a YMCA.
Pro tip: When your story hinges on how much weight you can lift, don’t post pictures of yourself at the gym, especially those where you bench press over 500 lbs.
Dross pled guilty to a felony count of workers’ compensation fraud, and was sentenced to nine months in jail, suspended for three years of community control, provided he remain employed and repay the $31,736.98 he’d collected.
The Wedding Ringer
An Arizona woman filed an insurance claim for her wedding ring, stating she lost her jewelry while swimming in the ocean. The, recently married, Maria Apodaca Simmons of Phoenix, AZ, filed her claim with Travelers Insurance policy received her funds without issue, and likely would never have been caught had she not turned greedy.
Five months later, she filed a second claim, this time for her husband’s wedding band, claiming it too was lost while swimming on vacation. The adjuster who interviewed Simmons regarding her husband’s ring noticed something rather odd. The ring she wore looked exactly like the one she claimed lost in the ocean.
Cue the Arizona Department of Insurance investigators, who discovered a Facebook page with a photo of Simmons wearing her “lost property” after the date of the Travelers claim.
The investigators executed a search warrant on Simmons’ residence in Phoenix in January, recovering the supposed ‘lost’ rings and uncovering the fraud.
Simmons attempted to lie, stating the ring was a duplicate. The jeweler who made the custom rings, however, told investigators he had only made one set.
She pled guilty to both counts of fraud.
As part of a plea agreement, Simmons was placed on probation, agreed to repay Travelers Insurance $26,953.60 to, and $1,005.11 to Arizona’s Department of Insurance for investigative costs.
Betrayed by YouTube
Investigators don’t always need your social media posts to catch you in a lie, as Andy House, an exotic car salvage yard owner, discovered following his own, rather dramatic, attempted fraud.
In late 2009, House bought a 2006 Bugatti Veyron for $1 million and insured the vehicle for $2.2 million. One month later, he was cruising along by a bay in Texas when, “he swerved into the water after he was reaching for his cell phone.”
Once House filed his claim, insurers began investigating. Unknown to House, another motorist had thought the cruising Bugatti quite the sight and had filmed the beautiful car as it navigated the highway. Of course, this person also caught the accident as well, and uploaded it to YouTube, where investigators later found it.
The video showed House driving the sports car straight off the road, and a swampy marsh by the Gulf Bay. He then left the car running in the water, which flooded the engine with saltwater and destroyed the vehicle.
Betrayed by YouTube: Part Two
It happened in the Valley back in October 2015.
Robert Atlas stated he had crashed his 2012 Corvette Stingray while exiting the I-10 freeway at Wild Horse Pass in Chandler, Ariz. GEICO paid Atlas $61,465.11 for the loss of his Corvette.
But a YouTube video posted by a local photographer shows what really happened.
In that video, a white Corvette sits on the start line of a drag strip, about to race a motorcycle. When given the green light, both vehicles launch to full speed. But the Corvette loses control halfway down the quarter-mile track, spinning out and hitting the concrete wall.
When the owner’s insurance company found that video, they confronted him with it. House admitted to filing a false claim with GEICO and was charged with insurance fraud.
On Jan. 25, 2017, Atlas pleaded guilty. As required by his plea agreement, he paid back GEICO in full. The court sentenced Atlas to two years supervised probation and assessed him $1,560 in court costs. Court documents show the drag racing Corvette owner “knew what he had done was wrong” and “stated that he wanted to repay GEICO.”
Facebook Isn’t Your Friend, Really
Set your profile to private. How many times do we have to say it? It’s common sense in our contemporary world, and it’s especially important when you’re posting photos that disprove that fraudulent insurance claim you filed.
This concept was too difficult for Jason Doyle Cook, a 44-year-old man from Utah. He filed a claim stating his truck had been damaged following a collision with a wooden post and a semi tire while driving on the freeway. Cook reported the crash damaged the bed of his truck and his rear brakes, while the trailer he was towing was rendered inoperable.
American Family Insurance conducted a social media search, and discovered a photo showing Cook’s truck had the same damage eight months prior to the supposed accident. Further photographic evidence showed that the damage existed long before Cook purchased the vehicle.
Cook was booked and released at Utah County Jail.