The Koyal Group Private Training Services: Tips and Tools for Insurance Fraud Investigations

Technology and social media are great tools used to investigate insurance fraud, according to expert panelists who spoke at the recent Risk and Insurance Management Society conference in Denver.

Susan LaBar, a risk manager for the bus company Coach USA/Megabus, and Scott Catron, senior vice president of Titan Investigative Alliance, provided tips for adjusters investigating suspected insurance fraud.

LaBar said she regularly gathers comprehensive information on both workers’ compensation and general liability claims. When a claim occurs, LaBar requests a detailed, five page report. It contains requests for nicknames, email addresses, hobbies, children’s names and hobbies, work history, college information and even pet information. This information helps when it comes time to conduct an internet and social media background investigation.

Catron discussed several technologies currently utilized in claims investigations. These include 3 D laser scanning, cross referencing multiple databases, mapping claims, remote surveillance and GPS and black boxes. He provided an example where mapping claims helped him discover two claimants that lived on the same street. This helped him when it came time to set up surveillance of the claimants.

Used to monitor vehicles, GPS and black boxes can be can be programmed to provide tire and off route alerts, according to LaBar. In addition, she said they can help verify whether or not a bus was in an area that a claimant claims an accident occurred. She added that buses outfitted with surveillance cameras can document hop-ons, claimants who hop on to a bus after a crash and claim an injury.

Catron explained the difference between a surface search and a deep internet search and provided tips on conducting internet investigations. He said a surface search involves using google and other search functions while a deep web search involves searches that lead to other databases, like court websites. Catron described how a deep internet search helped him find a regional race track website that contained damning photos of a claimant.

The seasoned investigator warned against friending claimants on social networks. He also emphasized the importance of confirming that the correct person is being investigated.

Sometimes claimants can get creative, they said. During past investigations both have encountered claimants who had two Facebook pages, one with the alleged injury and one without.

When screen shots are used as evidence, Catron said that it is important to note that whoever takes the screen shot will likely have to appear in court.

Catron also provided some surveillance tips that adjusters should consider when working with an investigator.

Adjusters should be aware that investigators:

• Can’t trespass;

• Can’t zoom into a residence;

• Can’t film over a privacy fence;

• Can’t climb trees;

• Must be in public view;

• Can’t participate in hard following (obvious tailing) because it is considered harassment;

• Can’t extract information by pretexting or lying about who they are.