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Ways of Spotting Fraudulent Claims

March 3, 2015 by  
Filed under Blog

Hundreds and thousands of insurance fraud cases, cost billions of dollars of loss to insurance companies each year in America. It has become a serious problem in the country, people are hatching more and more elaborate schemes to fool the insurance companies. But, thanks to insurance fraud investigation firms, like NSIU, the increase in fraud cases isn’t going unnoticed. We do our level best to root out the fraudulent claimants; here are some ways which help our investigators spot insurance fraud:

1.     History

A history of making a number of claims can be a prominent red flag. Investigators look at this history and try to discern a pattern of claims that the person in question has filed in the past. The results are then interpreted to see if the current claim is part of the pattern and if it is legitimate.

2.     Surveillance

Surveilling a claimant is one the best weapons investigators have, in their arsenal, to prove whether a person is lying about a bodily injury. Investigators tail the target and stake out their hangout spots to catch them performing a physical activity that they claimed they couldn’t.

3.     The Professionals

At times, a medical or legal professional will try to persuade a person to exaggerate their injuries in order to beef up their claim. They promise a percentage of the claim as a benefit; this is why looking at the professionals representing the claimants is of the utmost importance. Their past record can be instrumental in recognizing insurance fraud.

4.     Wrong Bills

Another way different professionals – often doctors or auto mechanics – commit insurance fraud is by billing the insurance company for services which were never performed, without the knowledge of the policy holder. Verifying the bills with the policy holder can help dissuade these kinds of insurance fraud schemes.

5.     Social Media

Social media canvass can reveal a lot about a claimant, people can post important details on social media, without realizing the magnitude of the information they are sharing. A picture of someone dancing, who is supposed to be bedridden, is enough to uncover an insurance fraud. NSIU provides a social media canvass service to its clients.

6.     Vigilance

Sometimes investigators receive help from policy holders that stay vigilant about their financial matters. They look at every bill and make sure that their insurance company is only paying for services they have received. They don’t let people drag them into their fraud schemes, and report any suspicious activities to the proper authorities.

7.     Check the Checks

Looking at the number of claim checks a single person is receiving can be a telltale sign of something fishy. If the same address is receiving checks in different names, then that is a clear sign of insurance fraud.

These 7 ways are often utilized by our expert investigators to catch fraudulent claimants. If you require the services of our SIU (Special Investigation Unit), then get in touch with us (800-960-6748) and let us know how we can help you.


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