Ever get that case that just doesn’t feel right? Medical adds up to supporting ongoing disability but something’s off about the claimant or what they said?
Fraudulent claims are real, but it takes evidence to prove. That’s when insurance surveillance and investigation become necessary.
Before you start
The primary goal of insurance surveillance is to establish a clear pattern of activities that provide evidence of a fraudulent claim.
One-off offenses can be dismissed as circumstantial, but repetitive behavior that indicates that the claimant may not have been truthful is substantial evidence. That’s why it’s suggested to plan for 3-5 days worth of surveillance.
Ensure reports detail all activity over this course of time. Video captured must prove beyond doubt - the subject is clearly identifiable and the offense obvious.
If the claimant has restrictions of no lifting over 15 lbs and is caught at the grocery store lifting 2 bags of groceries, that’s not exactly case-changing evidence. But helping a friend move and hitting the gym a day later screams fraud.
Claimants’ rights
Claimants have a right to privacy, all surveillance must take place in public. Do not enter the property of the subject. Do not peer through doorways or windows.
The subject must be in public view while being watched or filmed. Whatever the investigator can see from a public place is deemed not private. Surveillance must be conducted in a reasonable and unobtrusive manner. It is important to never engage in activity that is or could be perceived as harassment of the subject.
Background checks
Start by obtaining detailed background history through online sources and investigative databases. This information is critical when in the field.
Get a physical description of the subject and a photo.
What car do they drive and what’s the license plate number? Who else could be driving this vehicle? What other vehicles does the subject have access to?
Check social media, claimants may be posting the evidence you need without you having to do all the heavy lifting.
Pre-Surveillance
Identify the best location to track your subject, whether that be at home or work. Research Google maps, get a feel for the area. Scout the location and note all possible departure and return routes - by both car and on foot.
Find a strategic place to park your car. You want the best view of the subject and the least amount of attention drawn to you.
Most importantly, make sure they’ll be on-site during your surveillance. If they’re away on vacation or a business trip, you’re wasting your time.
Before you start
Prepare everything you need for your investigation and plan to be in your vehicle for an extended period of time, with no ability to vacate the vehicle if necessary.
Make sure you drive a boring vehicle, nothing that will draw attention to you. The goal is to hide in plain sight.
Have everything you need to last at least 24 hours - food, water, and other supplies. Make sure your gas tank is full. Windshield shades and blackout curtains or tinted windows certainly help to keep a low profile.
Have a change of clothes ready and multiple accessories in case you need to be on foot or just want to get more comfortable.
Arriving
Arriving at the surveillance point during the early morning hours can certainly help to avoid being seen parking your car. It’s especially suspicious if you don’t get out of the vehicle.
Consider having someone drop you off, park the vehicle, and walk away so it appears the vehicle is empty.
In the field
Be careful when working cases near places like playgrounds, schools, or anywhere children and families gather. You don’t want to draw unwanted attention. It’s also important to consider the legality of who is in your photos and videos in these particular circumstances.
Be diligent about taking notes and documenting the subject’s activities, but be careful not to flash your equipment. A pair of binoculars or a camera on the dashboard may appear suspicious.
Surveillance should be aborted if the subject becomes aware he or she is under surveillance.
Leave it to the experts
If evidence is needed in mediation, settlement conferences, or the Court of Law, US Claim Solutions has you covered. We have highly experienced investigators & surveillance professionals who specialize in collecting evidence with discretion and in a professional manner.
We’re here to service your claims needs 24 hours a day, 7 days a week, nationwide. Email us at customerservice@usclaimsolutions.co or give us a call at (888) 701-1153.
Sources:
https://blog.reduceyourworkerscomp.com/2018/04/5-tips-how-to-use-surveillance-to-prove-workers-comp-fraud/
https://totalsecurityadvisor.blr.com/emerging-issues-in-security/best-practices-successful-surveillance-operations/
https://www.traceinvestigations.com/best-practices-of-a-surveillance-investigation/
https://pursuitmag.com/surveillance-tactics-equipment-reports/
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