• Insurance Investigations

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    Insurance Investigations

    Insurance Investigations:

    In the world of investigations, the difference between a good investigator and a great investigator is often measured by their ability to conduct true, covert surveillance without being compromised. In the business, we call this “getting burned”. Not getting burned is the mark of someone who truly understands the craft of surveillance. Covert surveillance is an art just like any other.

    Positioning, equipment, intelligence, and undetected movement all fold into a successful surveillance or stakeout. However, the craft of surveillance is far from the TV show example of simply sitting in the back of a van with a camera across the street, it’s much more than that.

    True practitioners must know how to first obtain intelligence on their subject, then wait patiently for the opportunity. They must get on foot when needed, utilize different technology at every angle, and blend into their surroundings in any environment. Justice Solutions Group agents are some of the best in the business when it comes to the trade craft of surveillance, and our agents are dedicated to the practice. From years of undercover law enforcement and covert military experience, our agents have years of experience and technical equipment and expertise needed to get the photo and video evidence needed in any situation.



    Some of the ways surveillance agents and
    evidence can be used are:



    Infidelity and Cheating Spouse Investigations
    Child Support and Child Custody Cases
    Corporate Theft or AOE/COE Investigations

    Cohabitation Investigations
    Covert Video of Plaintiff for Trial
    And Much More

    Private Mortgage Insurance Fraud

    Mortgage insurance fraud occurs whenever a property owner or other individual participates in a scheme to avoid repayment of a mortgage that is backed by government or private insurance. Examples may include:

    • Making misleading statements about income, employment, or assets on a loan application for mortgage and/or an application for mortgage insurance.

    • Short sale fraud: PMI pays when a home is sold for less than is owed in a short sale. Short sale fraud can occur when a lender approves a sale of a home for less than the mortgage balance based on a misrepresentation of the property’s value.

    • Appraisal fraud: The value of a property is deliberately overstated so a borrower can obtain more money from a mortgage lender than the property is worth. The home ends up in foreclosure and the mortgage insurer ends up paying when the homeowner walks away.

    Workers Compensation Fraud 

    Workers’ compensation fraud occurs when someone willfully makes a false statement or conceals information in order to receive workers’ compensation benefits or prevents someone from receiving benefits to which they might be entitled.RCI investigators may be able to assist with the following services:

    • Surveillance – Investigators may use audio, video, and other types of surveillance to determine whether an individual worker is as injured as they claim.
    • 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.
    • Background checks and records research – An investigation into worker’s compensation fraud may include checking medical records, employment records, and other records. Private investigators may also run background checks to see whether a worker has filed numerous compensation claims in the past or if the company has a history of misclassifying employees.
    • Evidence gathering – Workers compensation investigators can gather evidence if they uncover workers compensation insurance investigations fraud. This can help employers and businesses prosecute fraud and cut off workers compensation claims that are not legitimate.

    Life & Health Care Insurance Fraud & Insurance Investigations

    An insurance fraud investigation is a type of fraud investigation that centers around attempts to benefit from deceitful claims. Seeking compensation for false or inflated claims is illegal, dangerous, and raises the price of insurance investigations for everyone.

    According to the Coalition Against Insurance Fraud, an estimated $80 billion is paid out annually in fraudulent insurance claims. This leads to the average household paying around $950 each year in higher premiums. In addition, being held liable in a staged accident can increase your risk of being sued.

    The prevalence of this type of fraud has resulted in insurance investigations companies acting with caution when paying claims, meaning you may need professional help when making your claim. RCIs’ insurance fraud investigation aids by revealing false claims. Don’t let your insurance premiums be a waste of money; use a RCI private investigator to safeguard your insurance privileges.

    There are several methods used to find information in an insurance investigations fraud. Most are used to determine whether claims are true or false. Here are a few commonly used techniques:

    Surveillance to verify the claim
    Medical reports/history search
    Previous claims/accidents search
    Insurance Investigations & Insurance coverage analysis
    Witness interviews
    Physician’s billing search and analysis
    Claimant background check

    Automobile Insurance Fraud & Insurance Investigations

    Fraudulent behavior falls into two categories. Hard insurance fraud refers to claims that are completely fabricated. Soft insurance fraud is when someone has a legitimate claim but inflates the value to make a profit.

    Insurance investigations covers a wide range of schemes and crimes. Fraudsters file false claims for:

    • Burglary and theft
    • Vehicle damage
    • Arson
    • Water damage
    • Personal injury
    • Loss of life
    • Health care and prescription costs

     

    From simply falsifying claims to engaging in mail fraud, identity theft, and forgery, fraudsters are always finding new ways to pull off their scams.

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