Fraudulent claims are common in the insurance industry. Whether you are an individual or an insurance company employee, you might not have enough time to investigate a case involving insurance fraud. This is where private investigators come in.
Private detectives in Texas and from the whole of US work on insurance-related matters such as automobile claims, arson and property damage claims, workers compensation claims, false disability claims, and medical claims among others. Some of the private investigation companies in Texas that handle insurance fraud include Kelmar Global, Get Evidence Now, Gradoni & Associates, Ash Investigations, All Star investigations, and Key investigations and many more. As a private investigator, one must be able to apply common sense, have the ability to make decisions quickly and also be able to make a sound judgement.
What is Insurance Fraud?
Insurance fraud refers to any duplicitous act executed with the purpose of obtaining improper payment from an insurance company. History shows that people from all walks of life can be involved in making fraudulent claims from insurance companies. People who can be involved in insurance fraud include doctors, lawyers, insurance agents, chiropractors, and many others. These individuals participate in insurance fraud through making false or exaggerated insurance claims in order to seek unjustified compensation for loses or injuries that were not actually suffered. Individuals could also be victims of insurance fraud when they are sold bogus or unlicensed insurance coverage by fraudulent insurance companies or when an insurance broker or agent diverts or steals the insurance premiums paid by the clients. There are two types of insurance fraud: hard fraud and soft fraud. Hard Fraud occurs when there is deliberate faking of an accident, arson, injury, theft or other losses in order to fraudulently collect money from insurance companies. On the other hand, soft fraud will occur when usually honest individuals exaggerate claims towards insurance companies for the purposes of maximizing benefits.
Insurance Fraud Cases
Different insurance companies in Texas have handled different insurance fraud cases.
ABC News reported of an incident where individuals attempted to fake injuries to collect disability payments from workers’ compensation programs that are strictly meant to help those with severe disabilities (Stohler & Pridgen, 2015).
On another incident, private detectives were put on a mission to capture the video of a farmer who attempted to fleece an insurance company (Stohler & Pridgen, 2015). The farmer had made fraudulent claims citing injuries from a car accident and that he wasn’t able to do daily farming because of these injuries. The investigators aimed at capturing anything that made him look like he was working. After hours of surveillance, the private detectives managed to film the farmer lifting heavy objects into his truck and they mentioned this incident as a starting point towards building their case.
On another case, a female perpetrator tried to scam an insurance company and her doctors as she attempted to keep her disability checks coming. Private detectives were able to capture her “on the job” at a gentleman’s club and were marveled at her ability to snake around a pole as someone with no pain or ache. This outcome really helped the investigators and their client in winning the case against the woman.
From these cases, one question could hit your mind- “how do private investigators succeed in their work?” The answer to this question is provided below.
How Private Investigators do their Work
Expert insurance fraud investigators use their knowledge, experience, and skills to gather the necessary evidence and information required to determine whether a claim is legitimate. Some companies prefer using female detectives since it’s not common for people to think of women as private investigators (Stohler & Pridgen, 2015). Also, the private detective job isn’t meant for everyone as only those who are willing to wait for something to happen are able to do it successfully. Some of the methods employed by the private detectives in their private investigations include photo and/ or video surveillance, witness interviews, GPS tracking, background checks, scene investigation, internet and social media monitoring among others.
Stohler, E. & Pridgen, T.(2015). How These Private Investigators Catch Workers’ Comp Fraudsters in the Act.
Houston’s Top Private Investigation Company
If you’re looking for a skilled private investigator in Houston, contact Gradoni & Associates today at 281-440-0800.