Insurance fraud is more widespread that you would think, and can affect any business or individual. From false workers’ comp claims to a car mechanic fabricating a bill for more repairs after a car accident, these are instances which can cost you money in increased premiums after your insurance company pays for exaggerated or completely made-up damages.
However, an experienced Upstate SC private investigator can help both insurers and their clients put a stop to this dishonest practice. Here are the things the PI can do to help uncover insurance fraud:
1. Analyze Documents for Editing
A combination of experience and specialized software helps PIs notice any inconsistencies in audio/video and documentary evidence submitted by a fraudulent claimant. There are many minute details that may not be obvious to an untrained eye, such as:
- Minute skips in the flow of motion in videos
- Wrong lighting or shadows in photos
- Different font, size and color in texts
- Seals and stamps that do not match perfectly the authentic ones used by authorities.
Such painstaking work enabled the US Immigration and Customs Enforcement expose several employees involved in a life insurance fraud ring, resulting in $1.9 million in losses to insurance companies.
2. Surveillance of People Suspected of Insurance Fraud
While private investigators cannot spy people into their homes, there is no law preventing them from observing their actions in plain view outdoors. Many people who file accident claims or workers’ comp claims are caught out, because they perform actions incompatible with the injuries they say they’ve suffered.
Thus, a PI may bring evidence that someone who claims workers comp for back pain was carrying heavy grocery bags. This is sufficient to dismiss their claim and press charges for insurance claim.
3. Examining Claimants’ Statements for Inconsistencies
In the advanced phases of an insurance claim, there are many statements and interviews given by the claimant. They all appear identical. However, a detailed comparative analysis will reveal inconsistencies, in terms of:
- When the accident happened
- How it happened
- The types of symptoms the person experienced
- What they did immediately after the accident.
Combing through many pages of statements is a painstaking work and you may overlook a critical element that may help you prove insurance fraud. Consult with an experienced PI and let them do this work on your behalf, with maximum competence and attention to detail.
4. Using Expert Witnesses to Debunk Suspicious Claims
Some claims stand out by the particular circumstances in which the events allegedly happened. A classic example is the New York staged car accidents scheme, which ran between 2017 and 2020, costing insurers up to $1 million. All these claims had the same elements: the accidents happened at night, on desolate roads. Thus, there were no witnesses, no traffic cameras and no other unbiased evidence available.
When a claim contains such extraordinary circumstances, a PI will start analyzing it using specialized resources, such as:
- Accident reconstructionists
- Medical experts
- Specialists in technical expertise for wrecked vehicles.
Their evidence can prove that the claimant’s version of the events is not only unlikely, but also impossible to have happened that way.
5. Obtaining Social Media Evidence
Many fraudulent claimants believe that enabling strict privacy settings on their social media profiles will prevent anyone from seeing their posts. In fact, based on reasonable suspicions, social media networks will make available a user’s posts to a private investigator.
And social media activity is one of the biggest sources of evidence against fraudsters. Many of them even brag to their friends about how they managed to trick the system. Others post photos and videos from parties and sports activities, while they state that they are suffering from unbearable pain in their insurance claims.
Let a Skilled Upstate SC Private Investigator Expose Insurance Fraud
Insurance fraud results in millions of dollars in losses to policyholders and insurance companies. This is an ever growing phenomenon, as fraudsters find more elaborate ways of filing false claims.
However, the buck stops the moment when an Upstate SC private investigator starts looking into the matter and exposing fraud with uncontested evidence. For your peace or mind, reach out to us and schedule a free initial consultation at: 864-671-4040!