Covert Surveillance: The Key to Cracking Down on Insurance Fraud

As an insurance professional, you understand the significant financial losses resulting from fraudulent claims each year. While some exaggerated or misleading claims are identified through standard verification processes, many slip through the cracks undetected. Covert surveillance has emerged as one of the most effective tools for catching perpetrators of insurance fraud red-handed. Conducting discreet monitoring and observation of suspicious claimants can reveal the truth behind falsified or exaggerated claims. Video and photographic evidence provides concrete evidence that is hard to dispute. For insurance companies seeking to curb losses from fraudulent activity, covert surveillance should be considered an essential strategy. Leveraging surveillance investigations to monitor questionable claims will lead to overall claims savings, deterrence of fraud, and more accurate settlement of legitimate claims.

Unveiling the Hidden Truth: The Role of Covert Video Surveillance in Insurance Claims Investigations

As an insurance provider, unveiling the truth behind suspicious claims is crucial to mitigating fraud losses. Covert video surveillance has become an invaluable tool for discreetly monitoring and gathering irrefutable evidence.

Capturing the Truth

Covert video surveillance involves carefully and strategically conducting mobile and stationary surveillance to monitor the activities of claimants who are exaggerating or feigning injuries. The footage obtained can provide definitive proof regarding the validity of claims by:

• Documenting a claimant’s actual functional abilities and activity levels versus what is reported. This may capture a claimant engaged in physical acts they claim they can no longer do.
• Recording inconsistencies in reports of pain, mobility issues or other alleged limitations. Footage may show no signs of discomfort or impairment.

The footage obtained may go beyond helping to prove the validity of a claim and will occasionally help in the formal fight against fraud by:

• Producing evidence that will allow a prosecuting attorney to prove outright criminal fraud, a challenging but possible hurdle to get over.

An Irreplaceable Advantage

Unlike witness statements or photos, video provides an impartial, comprehensive account of events that is difficult to dispute. Covert surveillance also avoids the possibility of a claimant modifying their behavior or activities because they know they are being monitored.

For insurance providers, covert video surveillance offers an unparalleled means of detecting deceitful claims and unjust payouts. When fraud is uncovered, legal action can be taken to recover funds, and deter future abuse. With fraud losses amounting to tens of billions per year, covert surveillance may be the key to unlocking critical savings and ensuring the viability of insurance systems.

Beyond the Lens: How Covert Video Surveillance Elevates Insurance Claims Investigations

Covert video surveillance provides a powerful means of detecting and preventing insurance fraud. When deployed strategically, hidden cameras can capture crucial evidence and insight into the daily activities of claimants that would otherwise remain unseen. This enables insurance carriers and their special investigative units (SIUs) to make more informed decisions about claims and pursue appropriate courses of action.

Surveillance provides an unparalleled view into a claimant’s actual functional abilities and levels of activity. It can reveal inconsistencies between what a claimant reports to their physician or insurance provider and their actions when unobserved. For example, covert video may show a claimant engaged in physically demanding yard work and home repairs despite claiming a debilitating work injury. This type of glaring discrepancy is difficult to refute and can be grounds for denying or terminating benefits.

Covert surveillance also allows SIUs to monitor claimants over a long time to identify patterns of fraud or abuse. What may appear to be an isolated suspicious activity could in fact be part of an organized scheme when viewed in the larger context. Prolonged observation helps investigators build a more comprehensive case and determine all parties involved before intervening. This approach aims to root out the totality of fraudulent activity, not just the visible portion.

Increasing the Odds of Success: Combining Other Investigation Services with Video Surveillance

While it is reasonable to expect surveillance video to be obtained by an investigator in most instances where surveillance is conducted, the objective should be to ensure that the video obtained is useful to the claims handling process.  Pairing covert surveillance with other investigative services can increase the odds of surveillance success.  For example:

• Background investigations can reveal useful information by identifying details regarding habits and activities.  For example, finding a record of business ownership can indicate when a subject may be leaving for work.  Social media posts may highlight an upcoming event that a subject will be attending.  Address records may reveal alternative locations where the subject may be residing.
•  Interviews of witnesses can identify information that can complement a surveillance investigation by uncovering details that may not have been found in a background investigation. For example, witnesses may have knowledge from prior conversations or observations that can provide an investigator with details that will assist in forming a surveillance strategy to yield useful video results.

Conclusion

In summary, covert video surveillance should be an integral part of any insurance carrier’s antifraud efforts. When used strategically alongside medical examinations, background checks, and witness interviews, stationary and mobile surveillance provide an unparalleled view into the realities of a claim and a powerful means of detecting deceit. With substantial payouts at stake, no tool is too small or insignificant if it helps bring the truth to light.

Insurance fraud costs individuals and companies billions each year, so insurance providers must take proactive measures to detect fraudulent activity as early as possible. Covert surveillance has proven to be one of the most effective tools for uncovering the truth behind suspicious claims and catching those committing fraud in the act. While it requires time, resources, and the expertise of experienced investigators and analysts, covert surveillance yields tangible results that make the investment worthwhile. By taking a vigilant, proactive approach to fraud detection through covert operations, insurance companies can crack down on fraud, reduce unnecessary costs and payments, and maintain affordable premiums for their legitimate policyholders. Though fraudsters may operate in secret, covert surveillance helps ensure their unlawful acts do not remain hidden for long.