Fraudulent claims account for a significant portion of all claims received by insurers, and cost billions of dollars annually. 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. Types of insurance fraud are diverse, and occur in all areas of insurance. Insurance crimes also range in severity, from slightly exaggerating claims to deliberately causing accidents or damage. Fraudulent activities affect the lives of innocent people, both directly through accidental or intentional injury or damage, and indirectly as these crimes cause insurance premiums to be higher.
As an insurance provider there is an obligation to investigate the possibility of fraudulent claims. Whether you are a direct provider or “Third Party Administrator” (TPA) your investors need to mitigate loss and save on large and permanent payouts by uncovering those individuals that are falsely collecting settlements and claims. According to the United States Federal Bureau of Investigation the most common schemes include: Premium Diversion, Fee Churning, Asset Diversion, and Workers Compensation Fraud.
At Diamond and Mann we get you what you need – the TRUTH.
Surveillance – This is perhaps one of the most effective tools in uncovering and demonstrating a fraudulent claim. Many times the “claimant” either has recovered well enough to return to full work status or they were never really injured in the first place. Our surveillance investigators are fully dedicated and are equipped with the latest in video surveillance cameras recording in full high definition. Currently we cover the entire state of Florida and all of southern Georgia and we are expanding every day. When assigned a surveillance case we don’t just stop there. We also include (at no additional fees) a social media check with the latest data search tools that help uncover postings that will undermine their claim. We also check local records for information and activities that can assist the adjuster and company in the proper course of actions either criminal or civil.
Workplace Accident Investigations – We can provide a fast response to a reported accident/claim injury. We will identify and interview witnesses. Photograph and measure the scene of the reported accident. We always look into the possibility of subrogation. You will be provided with a full and robust report and summary with embedded photographs to aid in the full comprehension of the reported accident and the condition of the scene at the time of the accident. Through proper investigation and full knowledge of the signs of insurance fraud our team has been very successful at uncovering fraudulent claims at the point of origin.
We also do Recorded Statements, Nationwide Background Checks, Social Media Checks and a host of other services that help you, the provider, know the truth.