Fraud committed against insurance companies is BIG business. Each year, an estimated 40 BILLION dollars is paid out worldwide due to insurance fraud. Not only do the companies lose, but the individual clients pay more in insurance premiums as a result. As a result, private investigators are often called in to investigate suspicious claims and if such activity is uncovered, the money paid can often be returned and the criminal prosecuted.
There are several types of insurance fraud cases that a private investigator may be hired to investigate including:
Theft/robbery claim fraud- This is an extremely common type of insurance fraud and it involves someone filing a claim on items that were supposedly stolen. In these cases, the items were often sold by the person filing the claim OR have just been hidden away as part of the crime.
Homeowners insurance fraud- Another common insurance fraud claim occurs when a homeowner claims damage to their home and seeks to recover to have it “fixed.” The homeowner may have caused the damage themselves to try to get paid by the insurance company (never intending to actually fix the home) or the damage may have never existed in the first place.
Auto accident fraud- An area of insurance fraud that is steadily on the rise involves auto accident fraud. In this type of case, a person will intentionally cause an auto accident and then claim medical damages. In some cases, both parties in the accident are working together which can help make their story that much more believable and uncovering the fraud that much harder to do. This type of fraud is a huge reason for auto insurance premium increases.
Health care fraud- Someone who claims to have an illness and collects payments associated but does NOT have that illness is committing health care fraud. These cases can be extremely expensive and often include the “patient” visiting numerous doctors and hospitals and receiving a plethora of prescription medication as part of their scheme.
Workers compensation fraud- Getting hurt on the job can certainly be a horrible experience and when this happens to someone, you certainly want them to be compensated for the injury sustained while performing their task. All too often, however, these “injuries” are completely faked, and the person is instead completely healthy and injury free but collecting enormous sums of money for their claim. These cases can result in HUGE payouts and often require a private investigator to be employed for months or even years as they collect evidence on the suspected party. For instance, an individual may claim a debilitating back injury sustained at work and be awarded a payment equal to several times their regular salary. The private investigator may then capture video or photographic evidence of this person lifting heavy objects, playing sports, etc. thereby proving their claim is a lie.
Life insurance fraud- Life insurance fraud cases can also involve huge payouts, even into the millions of dollars. In these scenarios, an individual may claim they help much more insurance than they did in the case of a loved one who has recently passed. IN other scenarios, a person may try to collect on a policy in a case of a faked death (the insured is still alive.) In still other cases of life insurance fraud, an individual may purchase a policy on an individual to collect when that person really dies, but they may not have “insurance interest” on that person. IE you can’t just purchase a policy on anyone, you must be able to demonstrate a financial relationship such as you are family, you are partners in a company, etc. The person insured also must sign off on the policy as well so in these cases a forged signature is often uncovered leading to the exposing of the fraud.
So, the next time you are paying your insurance bill, you can rest assured that a portion of the amount due is directly related to insurance fraud. You can also thank private investigators for helping to keep the bill down as much as possible by helping to recover hundreds of millions (and even billions) of dollars annually that had been paid out from the insurance companies due to this fraudulent criminal behavior.
