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Insurance Fraud, The Fraud Chronicles 4: Where Can You Hide In The Middle Of A Field?
by Tom Reitze
When an insurance claim contains red flag indicators of potential fraud and an assertion of total disability, it is appropriate and sensible to discreetly document the claimant's activities on film to verify or discredit the claim. This is known as surveillance. If the person isn't really disabled, chances are the investigator will catch and film them doing something that a truly disabled person would not be able to do. DMA Claims Services (http://www.dmaclaims.com/investigations.shtml) investigates suspicious cases, conducts surveillance, and if an insurance claim is found to be fraudulent, turns the information over to the insurance company. This is a case from the DMA Investigations archives, Part 4 of the Fraud Chronicles, and involves a case where the investigator had to be inventive to get the film without tipping off the "disabled" person doing heavy farm work. Where Can You Hide in the Middle of a Field? Andy Schwarz, Investigations Manager Los Angeles, DMA Investigations "A first rule of surveillance in rural areas is: When in Rome do as the Romans do. Or perhaps better stated: Look like what a Roman would expect a stranger to look like. For the last several years in many situations that has meant: look like you are interested in buying real estate. "Our assignment involved a claimant alleging total disability, and he was located near a small (population 400) farming community in the middle of Missouri. I arrived just prior to Labor Day weekend and quickly realized this was not going to be a walk in the park. "First, the Mapquest to the claimant's only known address led to the fifth row of a cornfield. "Second, Labor Day was approaching rapidly and every store and public facility in town was closing. We knocked on the door of the tiny City Hall, the only known repository of records, but got no answer. It looked like it was shut down tight already. Main Street was deserted. But the experienced investigator knows where he can get information even when faced with such daunting absences - the nearest bar. "Finding the bar was easy, but soon I was striking out once again. Asked about land I 'heard' our claimant had for sale, the bartender knew nothing. The few patrons in the place knew nothing. I stepped back into the dusty street with an uneasy feeling and not one good idea of where to go next. "But I was rewarded for not staying in the bar to enjoy several cold ones and feel sorry for myself. A woman approached and asked if I had knocked on her door. Turns out she was City Hall staff, by herself in the office and on the phone, thus unable to answer the door. One thing led to another and pretty soon I was studying a map showing the location of every house in town. "I soon arrived at the residence I found on the map, and confirmed it was the home of our claimant. But the test of investigator will was not over. There was no activity. I waited and still nothing, totally quiet. "Some digging was in order and once again I resorted to an establishment purveying liquid refreshment. This time, closer to the residence, I came up with what I needed. The claimant was possibly building a house in a nearby town, and was known to be in Southern Missouri attending a wedding. Best of all he was expected to be home later that night.
"The next day I followed the claimant from his house out to a farm ten miles outside of town. That was easy, but it turned out this assignment, as a test of investigator will, was the proverbial Bar Exam or SAT. There was no place to park outside of obvious view. Farmhouse, fields and the road - that was all there was. No trees, no stone outcrops, not another parked car within five miles. No hills with vantage points from which to view the farm.
"Your tireless investigator proceeded to the last resort - staging a vehicle breakdown off the side of the highway just beyond the claimant's farm (and disconnecting the battery in case the claimant proved to be a helpful type, which he did not). The claimant ignored the vehicle with its hood up and just continued with his farm work. I was thankful for this attitude as I sat in the back with video rolling.
"As any professor of agriculture (or five year old child) will tell you, farm work is not an appropriate use of time for the totally disabled. Just looking at the video of our claimant cruising by on a tractor, bouncing around over rough ground, and manhandling bales of hay makes me want to lie down and take a nap. "Our film was the end of that claim. And in my estimation, a pass with flying colors on this particular test of investigator will." Another victory for truth, justice and lower insurance premiums.
Tom Reitze is President of DMA Claims Services (http://www.dmaclaims.com), an independent claims adjusting and investigations company with 42 offices in 16 states.
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Insurance fraud, The Fraud Chronicles 3: Wicked Witch Of Insurance Fraud by Tom Reitze Approximately 719 Words
Appearances can be deceiving. Some older lady might remind you of your grandmother, until she starts filing fraudulent insurance claims. At that point, the proper action is not to throw water on her but to document the fraud and turn it over to the authorities. DMA Claims Services (http://www.dmaclaims.com/investigations.shtml) investigates, conducts surveillance, and if an insurance claim is found to be fraudulent, turns the information over to the insurance company and the proper authorities. And when that happens, the wicked witch isn't going to melt, just end up doing some time in a small room...
Insurance fraud, The Fraud Chronicles 2: You Insulted My Equipment! by Tom Reitze Approximately 645 Words
When someone commits insurance fraud, such as claiming to be injured or disabled from a work-related incident when they are not, honest people suffer through higher insurance premiums. 25% of all insurance premiums go to pay for fraudulent claims, just so some bad guys can live the high life and avoid working. But DMA Claims Services (http://www.dmaclaims.com/investigations.shtml) is fighting the bad guys one at a time by investigating, conducting surveillance, and if their claim is found to be fraudulent, busting them! And when that happens, everybody wins - except for the bad guys of course. No more high life for them...
Insurance fraud, The Fraud Chronicles Part 1: Dancing On Disability by Tom Reitze Approximately 756 Words
Insurance fraud is an exploding problem in America. Most consumers don't realize that 25 percent of their insurance premiums are used to pay fraudulent claims. But some are fighting back. Some investigations companies like DMA Investigations (http://www.dmaclaims.com/investigations.shtml) are working hard to uncover insurance fraud and bust the perpetrators. In many cases, this involves someone who has filed a claim for partial or total disability. We then conduct surveillance on that person to see if they really are disabled, and often we film them in the act of doing something that a totally disabled person definitely could not do. When that happens, that claim goes away and oftentimes that person will be prosecuted for fraud...
Insurance, The Truck Chronicles: Part I by Tom Reitze Approximately 1016 Words
DMA Claims Services (www.dmaclaims.com/bulletproof.shtml) is an independent claims adjusting company that handles many claims for accidents involving truck drivers. Getting into an accident with a big 18-wheeler can be a scary experience, but sometimes the driver of the car will see a big cash register going "cha-ching" in their minds. And many times the settlements in such cases can be huge. But what if the truck driver wasn't at fault? And worse, what would happen if the Highway Patrol incorrectly said that he was? This is Part I of "The Truck Chronicles," stories of DMA Claims Services' claims adjusters handling truck accident claims. This one is by Pat Daugherty, a DMA truck adjuster in the 1980's, and subsequently DMA's Seattle branch manager...
You may want to try these websites for additional information
http://www.fldfs.com/
http://www.insurancefraud.org/protect_yourself_set.html
http://www.helpstopfraud.org/
The information provided in this article is the express opinion of the author. Exchangenet is not responsible for the content!
When an insurance claim contains red flag indicators of potential fraud and an assertion of total disability, it is appropriate and sensible to discreetly document the claimant's activities on film to verify or discredit the claim. This is known as surveillance. If the person isn't really disabled, chances are the investigator will catch and film them doing something that a truly disabled person would not be able to do. DMA Claims Services (http://www.dmaclaims.com/investigations.shtml) investigates suspicious cases, conducts surveillance, and if an insurance claim is found to be fraudulent, turns the information over to the insurance company. This is a case from the DMA Investigations archives, Part 4 of the Fraud Chronicles, and involves a case where the investigator had to be inventive to get the film without tipping off the "disabled" person doing heavy farm work. Where Can You Hide in the Middle of a Field? Andy Schwarz, Investigations Manager Los Angeles, DMA Investigations "A first rule of surveillance in rural areas is: When in Rome do as the Romans do. Or perhaps better stated: Look like what a Roman would expect a stranger to look like. For the last several years in many situations that has meant: look like you are interested in buying real estate. "Our assignment involved a claimant alleging total disability, and he was located near a small (population 400) farming community in the middle of Missouri. I arrived just prior to Labor Day weekend and quickly realized this was not going to be a walk in the park. "First, the Mapquest to the claimant's only known address led to the fifth row of a cornfield. "Second, Labor Day was approaching rapidly and every store and public facility in town was closing. We knocked on the door of the tiny City Hall, the only known repository of records, but got no answer. It looked like it was shut down tight already. Main Street was deserted. But the experienced investigator knows where he can get information even when faced with such daunting absences - the nearest bar. "Finding the bar was easy, but soon I was striking out once again. Asked about land I 'heard' our claimant had for sale, the bartender knew nothing. The few patrons in the place knew nothing. I stepped back into the dusty street with an uneasy feeling and not one good idea of where to go next. "But I was rewarded for not staying in the bar to enjoy several cold ones and feel sorry for myself. A woman approached and asked if I had knocked on her door. Turns out she was City Hall staff, by herself in the office and on the phone, thus unable to answer the door. One thing led to another and pretty soon I was studying a map showing the location of every house in town. "I soon arrived at the residence I found on the map, and confirmed it was the home of our claimant. But the test of investigator will was not over. There was no activity. I waited and still nothing, totally quiet. "Some digging was in order and once again I resorted to an establishment purveying liquid refreshment. This time, closer to the residence, I came up with what I needed. The claimant was possibly building a house in a nearby town, and was known to be in Southern Missouri attending a wedding. Best of all he was expected to be home later that night.
"The next day I followed the claimant from his house out to a farm ten miles outside of town. That was easy, but it turned out this assignment, as a test of investigator will, was the proverbial Bar Exam or SAT. There was no place to park outside of obvious view. Farmhouse, fields and the road - that was all there was. No trees, no stone outcrops, not another parked car within five miles. No hills with vantage points from which to view the farm.
"Your tireless investigator proceeded to the last resort - staging a vehicle breakdown off the side of the highway just beyond the claimant's farm (and disconnecting the battery in case the claimant proved to be a helpful type, which he did not). The claimant ignored the vehicle with its hood up and just continued with his farm work. I was thankful for this attitude as I sat in the back with video rolling.
"As any professor of agriculture (or five year old child) will tell you, farm work is not an appropriate use of time for the totally disabled. Just looking at the video of our claimant cruising by on a tractor, bouncing around over rough ground, and manhandling bales of hay makes me want to lie down and take a nap. "Our film was the end of that claim. And in my estimation, a pass with flying colors on this particular test of investigator will." Another victory for truth, justice and lower insurance premiums.
Tom Reitze is President of DMA Claims Services (http://www.dmaclaims.com), an independent claims adjusting and investigations company with 42 offices in 16 states.
These articles on lifestyle and more
Feel free to distribute this artice but keep the links "click able". insurance fraud
Return to the selection of insurance fraud
You may want to try these articles from Tom Reitze
Insurance fraud, The Fraud Chronicles 3: Wicked Witch Of Insurance Fraud by Tom Reitze Approximately 719 Words
Appearances can be deceiving. Some older lady might remind you of your grandmother, until she starts filing fraudulent insurance claims. At that point, the proper action is not to throw water on her but to document the fraud and turn it over to the authorities. DMA Claims Services (http://www.dmaclaims.com/investigations.shtml) investigates, conducts surveillance, and if an insurance claim is found to be fraudulent, turns the information over to the insurance company and the proper authorities. And when that happens, the wicked witch isn't going to melt, just end up doing some time in a small room...
Insurance fraud, The Fraud Chronicles 2: You Insulted My Equipment! by Tom Reitze Approximately 645 Words
When someone commits insurance fraud, such as claiming to be injured or disabled from a work-related incident when they are not, honest people suffer through higher insurance premiums. 25% of all insurance premiums go to pay for fraudulent claims, just so some bad guys can live the high life and avoid working. But DMA Claims Services (http://www.dmaclaims.com/investigations.shtml) is fighting the bad guys one at a time by investigating, conducting surveillance, and if their claim is found to be fraudulent, busting them! And when that happens, everybody wins - except for the bad guys of course. No more high life for them...
Insurance fraud, The Fraud Chronicles Part 1: Dancing On Disability by Tom Reitze Approximately 756 Words
Insurance fraud is an exploding problem in America. Most consumers don't realize that 25 percent of their insurance premiums are used to pay fraudulent claims. But some are fighting back. Some investigations companies like DMA Investigations (http://www.dmaclaims.com/investigations.shtml) are working hard to uncover insurance fraud and bust the perpetrators. In many cases, this involves someone who has filed a claim for partial or total disability. We then conduct surveillance on that person to see if they really are disabled, and often we film them in the act of doing something that a totally disabled person definitely could not do. When that happens, that claim goes away and oftentimes that person will be prosecuted for fraud...
Insurance, The Truck Chronicles: Part I by Tom Reitze Approximately 1016 Words
DMA Claims Services (www.dmaclaims.com/bulletproof.shtml) is an independent claims adjusting company that handles many claims for accidents involving truck drivers. Getting into an accident with a big 18-wheeler can be a scary experience, but sometimes the driver of the car will see a big cash register going "cha-ching" in their minds. And many times the settlements in such cases can be huge. But what if the truck driver wasn't at fault? And worse, what would happen if the Highway Patrol incorrectly said that he was? This is Part I of "The Truck Chronicles," stories of DMA Claims Services' claims adjusters handling truck accident claims. This one is by Pat Daugherty, a DMA truck adjuster in the 1980's, and subsequently DMA's Seattle branch manager...
You may want to try these websites for additional information
http://www.fldfs.com/
http://www.insurancefraud.org/protect_yourself_set.html
http://www.helpstopfraud.org/
The information provided in this article is the express opinion of the author. Exchangenet is not responsible for the content!