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Fraudulent
Insurance Claims
Fraud;
as defined by Funk & Wagnells dictionary: "Deception
in order to gain by another's loss; craft;
trickery; guile. Any artifice or deception
practiced to cheat, deceive, or circumvent another
to his injury."
Wade
Thomas & Associates works with Special
Investigative Units, Claims Departments, or Law
Firms, to investigate fraud or to prove a claim is
founded. Claims in the insurance industry are
skyrocketing, and a large number of those claims
are exaggerated or just completely false.
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We
can handle:
-Fraudulent Claims
-Civil Liability Claims
-Workman's Compensation Claims
-Vehicular Accident Claims -
auto, truck, pedestrian
-Slip and Fall Claims
-Personal Injury Claims |
Fraud
in the insurance industry is widespread and
usually consists of a false or exaggerated claim.
The common method is to inflate losses or injuries
incurred from an incident for which insurance
coverage is held. The majority of claimants
exploit their injuries beyond belief in an effort
to maximize their claims.
If
you see or hear any of the following warning
signs, you may want to consider surveillance.
*The claimant is never home to answer the phone or
is always "sleeping and cannot be
disturbed."
*The claimant's alleged injury coincides with job
layoffs or facility closing.
*Leads or tips from fellow employees that the
subject is active and is observed often (involved
in sports or recreational activities, etc.).
*Rehabilitation reports indicate that the claimant
is suntanned, maintains good muscular strength,
calluses, bruises, cuts, dirty hands.
*Claimant's spouse is employed away from the home
and the claimant has small children.
*Claimant was or is in line for "early
retirement."
*Claimant receives mail at a post office box and
is reluctant to divulge actual place of residence.
*Claimant has a history of self-employment or is
in a trade that is capable of working for
"cash money" while feigning a work
related injury.
*Claimant has relocated place of residence, either
out of state or remains secretive about new
residence.
*Excessive demands for compensation.
*A history of malingering by the claimant.
*"Dueling Doctors" - changes doctors
frequently until one agrees with the claimant or
one doctor says the claimant is injured, the other
says the opposite.
Obviously this is only a guide, but take the time
to apply some of these tips to your cases. If any
of the above indicators sound familiar, you may
want to consider surveillance.
Our services include:
- Interviewing witnesses with oral, recorded, and
signed statements.
- Background investigations of plaintiff or
defendant.
- If warranted, we will conduct video surveillance
to further ascertain social, employment and
recreational activities.
- Professional rendering of our findings for
presentation during subsequent hearings or
litigation.
Our typical investigation would determine the
claimant's current activities, any full or
part-time employment held since the date of loss,
dependents, household income, health status, civil
or criminal litigation's, and recreational or
strenuous activities. We can also check to
determine whether the claimant has had any
previous workers compensation claims and obtain a
copy of the claimant's driving history.
We investigate these claims to determine if in
fact an employee has faked or exaggerated their
injuries, has unreported income, has employment at
a second job, or has multiple claims under
multiple identities. We can thoroughly investigate
and document suspicious claims, thereby providing
the client a legal basis for denying unjustified
claims or honoring those that are shown to be
legitimate.
Surveillance is conducted to obtain photographic
or video-taped results of claimants engaging in
recreational activities inconsistent with their
claimed injury. We may find the individual working
"under the table" to circumvent the
purported injury. This can greatly reduce the
demand and help speed up the settlement process.
We provide the client with a comprehensive written
report relative to the findings of our
investigation. Most cases can be completed within
two to three weeks.
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