How Does All Investigative Services Investigate Insurance Fraud?
The total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year, according to the Federal Bureau of Investigations. That means insurance fraud costs the average U.S. family between $400 and $700 per year in the form of increased premiums.
There are many types of insurance fraud — including automobile insurance fraud, workers’ compensation claimant insurance fraud, workers’ compensation premium evasion insurance fraud, property insurance fraud, provider fraud and more. As investigators, we realize that insurance fraud has become a major problem in the United States. The people who commit insurance fraud are increasingly creative and our investigators at All Investigative are always increasing awareness on these tactics. While there are plenty of common scams out there -- like pretending you lost an expensive piece of jewelry, then filing a claim -- fraudsters also perpetrate scams by, say, staging accidents. Insurance companies and the public need to be keenly aware of these scams.
Just as there are different types of fraud and fraud-related crimes, there are also different types of fraud investigations. Insurance fraud investigations, for example, work to uncover those who have made false claims to get insurance money. On the other hand, workers’ compensation investigations are initiated to uncover employees who have attempted to falsely claim compensation for injuries that do not exist.
Fraud investigations can be challenging for several reasons. First, criminals are skilled in their craft and will make extra effort to conceal their crimes. Secondly, our investigators need to prove that fraud was intended in order for an investigation to be used in a legal case. Our qualified investigators will successfully complete these facets of a fraud investigation. Our investigators have over 30 years of training and education to complete an investigation successfully.
Before an investigation begins, our investigator works to gather all facts from the client. During an initial meeting, the person launching the investigation should explain why they suspect fraud has taken place. At this time, they may also hand over evidence to the investigator. This information will be used for further research. Surveillance, asset searches, background checks and other types of investigative methods may also be used to complete the investigation.
The investigators at All Investigative Services ensure that every case is pursued in a legal, ethical and professional manner.
Many attorneys do not realize the need for investigators in cases. However, having an investigator can make or break a case. They also add a quality and a variety of skills and resources that can prove to be crucial in determining the outcome. An investigators expert testimony is valued heavily in the courts.
An experienced investigator knows how to work with an attorney to get to the bottom of a scenario. Together, they can unravel many answers.
Although law school and career experience provide an attorney with a number of useful research techniques and litigation skill, they do have limits.
Consulting with a professional private investigator can help attorney’s to leverage their position and find creative and efficient ways to come out ahead of an adversary.
Here are some ways that an attorney can use a professional private investigator:1
It may be a witness or a birth parent. Perhaps it’s a former employee or an heir. There are ways that an investigator can locate missing or difficult to find individuals who can shed light on a situation. Investigator Robert Hopes investigated a situation of employee misconduct for a local healthcare company. Hopes says one of his most interesting cases was one where he needed to locate a witness in possession of the proverbial “smoking gun.” He felt that the witnesses statement is what won a multi-million dollar lawsuit for a client of The Sanders Firm, a Nassau based personal injury attorney practice. Whether you would like to interview, serve, or investigate someone, an investigator can help you to identify and locate the individual.
Another way that investigators can help attorneys is to locate assets. Investigators are skilled at locating real estate, bank accounts, businesses, valuable property (artwork, antiques, collectibles, etc.), and vehicles (motor vehicles, aircraft, vessels, etc.). An investigator can also help attorneys to identify the location both domestic and offshore bank accounts (though the details of these assets may not necessarily be disclosed by banking institutions without court order or permission from the account holder).
3Leverage for Negotiations
An investigator can pull together key sources and intelligence to inform your side during litigation, an M &A deal, internal investigation, or any other adversarial situation that can make the difference between a favorable settlement.
A judgment is only useful if you are able to enforce it. An investigator can help attorneys to identify current assets and any efforts to hide or misrepresent them through the transfer to family members, friends or other parties.
5Connect the Dots
Investigators can help you to know who is actually sitting on the other side of the table during litigation or a potential business deal. You can gain immeasurable negotiation power by identifying who is actually behind a faceless corporation or tying together undisclosed connections.
6Predict Your Opponent’s Next Move
Through an investigation, you can learn your opponent’s history and patterns of behaviors so as to best predict how they will react under pressure. This will help you to be successful in litigation strategizing, during cross examination, or at the deal table.
7Prep For Cross Examination
During preparation for a deposition or courtroom testimony, an investigator’s report detailing your witnesses’ weaknesses, background, and behavioral tendencies may be one of your most valuable tools. This can also be useful in identifying information against your client, so you can be prepared for what may come up during the course of the litigation.
8Collect and review electronic evidence
Whether it is an adversarial matter or an internal investigation, investigators may be used to efficiently recover electronic files – including those that a subject believes he or she has successfully deleted. Investigators are frequently used to identify and analyze a subject’s emails, documents, or other files.
9Trademark and Intellectual Property Monitoring
Investigators can be used to successfully police a company’s products throughout the world. Counterfeiting and improper diversion of products onto the grey market are just two of the most common areas where an investigator can provide intelligence and assistance.
A historical reconstruction may be helpful in a number of different areas. Perhaps you need to review the history of a family to locate heirs. It could be a corporate history or a chain of title issue in a real estate matter. Whatever the issue, an investigator can help to identify and piece together long lost documents, facts and witnesses.
We live in an age of instant media and pervasive social networking. Any event, public or private, has the potential to be recorded as it happens. Events which give rise to claims and litigation are no exception. Incidents are now more frequently recorded by private surveillance cameras – for example, a slip and fall may be captured on a security camera, or a car accident recorded by a driver’s dash camera. Similarly, events may be commented upon and photos or video uploaded to social media, often as it happens. For example, Twitter allows users to broadcast in real time, even without a computer. The details of any accident can be immediately captured and shared via smart phone by the injured party, his friend, co-worker and/or supervisor, or witness who may or may not have the potential parties’ interests at heart.
Surveillance and social media are also frequently utilized by attorneys during litigation. Defense attorneys at Cohen, Forman and Barone have used videotaping surveillance for allegedly injured plaintiffs, and are now also gathering information from social networking sites to determine whether or not a plaintiff’s claimed injuries are legitimate. They have recently employed surveillance during litigation by surreptitiously videotaping the plaintiff’s independent medical examination in an effort to discredit the examining doctor.
Carla Barone, a matrimonial attorney at Cohen, Forman and Barone has used social media surveillance to help her clients in highly contested divorce and custody cases in Nassau County, Long Island.
Having an investigator determine what a parent is doing can help to show good or bad parenting and will help the outcome.
To contact Mr. Hopes call: 516.654.9725
To contact an attorney at The Sanders Firm call 516.741.5252 or 1.800.FAIR.PLAY
For Cohen, Forman & Barone call: 631.776.9111
Author: K. Murphy
Karin Murphy is an investigative reporter for BonkoTV, LI Best,DailyBlu, All Investigative & LinkedIn News, a recipient of the The Folio Awards in social media and content, and recipient of Long Island Museum Gold Award For Technology/Content Development. Karin is always looking for good investigative story ideas of national interest. Email: Karin@KarinMurphy.com
When serious injuries result from the negligence of property owners or managers, victims are urged to speak with an experienced NY premises liability attorney to determine their best course of action. Usually, attorneys will recommend an investigator to determine the conditions of the premises.
At The Sanders Firm, located in Mineola, NY, investigators are called in to take pictures and evaluate the premises. Immediately the attorneys can ascertain the conditions and if there was any wrong-doing. "The Sanders Firm has been helping people for 50 years and we are committed to making sure our clients are getting the results they desire. They need us to guide the way. From hiring instigators to trial, we consult every step of the way. If business or property owners were negligent in maintaining the safety of their buildings and grounds, they may be held accountable for any injuries you sustained" said Founder, Stanley Sanders.
By law, New York property owners and business establishments have certain legal duties to visitors and patrons. When property owners ignore this duty, or otherwise allow hazardous conditions in public areas to exist or remain, they may be held liable for any injuries sustained as a result of such negligence.
It's important to understand how attorneys can be helpful in the process of investigations. If you think there may be negligence in a scenario you have been involved in, it may be prudent to speak to an attorney like Stan Sanders. Their number is 1.800.FAIR.PLAY if you need to consult.
Karin Murphy is an investigative reporter. Through her own experiences she took an interest in undercover & investigative work.