Eight Methods Used To Detect Insurance Fraud In A Maryland Workers Compensation Claim Or An Auto Accident Claim

What 8 methods do private investigators use to try to detect insurance fraud in a Maryland Workers Compensation claim or an auto accident claim?

  1. Surveillance – Investigators may use audio, video, and other types of surveillance to determine whether an individual worker is as injured as they claim.
  2. Interviews and research – Workers compensation investigators may interview colleagues, friends, family, and other individuals to learn whether there is an issue of fraud and, if so, how great.
  3. Background checks and records research – An investigation into worker’s compensation fraud may include checking medical records, employment records, and other records.
  4. Private investigators may also run background checks to see whether a worker has filed numerous compensation claims in the past
  5. The investigator will monitor the individual’s activities.
  6. The investigator will review medical records, employment records, business/asset records, and the ISO Index of criminal records and previous injuries.
  7. Social media can be an effective means to discover information during an investigation. Social media can aid in an investigation by offering a photo of the injured person so the subject can be correctly identified prior to surveillance. In addition, investigators can use social media sites to documents activities in which the injured may be involved. If there is a question as to the residence of an individual, social media may reveal a photo taken in front of a house. A completed Facebook profile can contain up to 40 pieces of personal information. Photos found on social media sites may include metadata that can offer details on a person’s location and date. Social media sites documents activities in which the injured may be involved. Employers do need to be cautious about how they employ social media tools to investigate their employees’ behaviors. It is impermissible to trick an employee in order to obtain access to their Facebook page, tweets or other social media postings. However, if the information is open to the public, or if an employee’s social media information is not privacy protected, then an employer is permitted to use information that they gather from social media websites to defend claims.
  8. Many employers within this state currently have video surveillance installed at key locations on their premises. Thus, the use of video can be employed to determine whether an injury actually occurred, thereby providing the employer with a viable basis for rejecting the claim on a good faith basis and ultimately prevailing at the time of trial. If the employee insists that the injury occurred on a specific date and time at a precise location, and the film does not reflect any accident or injury, proof will be adduced that the incident did not occur. Alternatively, film could reveal that the employee intentionally self-inflicted the injury, which would provide the employer with the affirmative defense. Additionally, where the employee claims that the injury was caused by his altercation with a co-employee, film can graphically reveal the identity of the individual who is the initial physical aggressor

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