Social media websites are often a great source of information for fraud investigators. These sites are a place where people post every little detail of their day-to-day lives. This information is handy for investigators, especially when claimants post things about their frequent activity while they are supposedly disabled and collecting workers' compensation.
The most recent issue of the Journal of Insurance Fraud in America (JIFA), published this summer, details how legal professionals, investigators, and other insurance company representatives sometimes deceive suspects into giving up information from these sites. Jim Quiggle, director of communications at the Coalition Against Insurance Fraud (CAIF), explained that social media is the up-and-coming source of potential evidence in any kind of fraud investigation.
“Everybody is mining social media for clues in fraud investigations,” Quiggle said. “People love to brag about their exploits on those sites. A person can tell all their friends how he or she scammed an insurer—people cannot resist the impulse.”
Right now, states have varying laws as to how lawyers, agents, investigators, and other insurance company representatives can engage in deception in investigations. Jaclyn Millner, an attorney with Liberty Mutual and one of the two legal experts who authored the piece in the JIFA, explained that states are looking to other states as these rules are modified.
These templates include rules for obtaining evidence and ethical rules for lawyers, but one rule that stands out is the rule of deceit in investigations—some states have exceptions and allow deceit if fraud is reasonably expected, but that is the minority.
Although some cases may be more difficult than others, Quiggle said “if you follow the rules of reasonable discovery, then you should be able to find most material if you need it.”
Getting Put on the Spot
Millner detailed one case in which a claimant's Facebook account proved a lack in injury, although the claimant had previously filed for workers' compensation.
The employee had claimed a back injury and was requesting payment of medical bills as well as wage loss from work. However, photos on the claimant's Facebook profile showed the claimant climbing on a ropes course, bowling, lifting weights, and more.
“In almost any case, I think it's worth doing an initial search of the most common social media sites,” Millner said. “It only takes a minute or two, and that person you're looking for may have a public profile. Once there is something suspected, look at other sites like YouTube where you may find things that contradict a claimant's allegations.”
Quiggle agreed, explaining that “people love to post their action-packed photos even though they have informed their workers' comp insurer of a 75 percent disability and the need for immediate bed rest.”
Once these claimants are put through further questioning, Quiggle said many admit to fraud. “It's not unusual for suspects to cave, because it's just hard to deny the undeniable.”
It is no wonder that these tell-all websites are of great value to investigators. People love to brag about their accomplishments, and these sites just happen to document and time stamp each and every one of them.
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