Complex claim investigations involving surveillance often require techniques outside the traditional scope of manned surveillance. Unmanned remote surveillance is the culmination of current technology developed out of the necessity to better investigate complex insurance claims.

“Remote surveillance is a much-needed investigative option within the claim community,” said Andy Porter, regional special investigative unit manager of Zurich Insurance. “Conducted in a legal and ethical manner, it provides a unique and specialized surveillance option to claim professionals.”

The technology now is commercially available as an affordable option to many claim handlers. Previously, such surveillance solutions were used only by certain three letter government agencies with deep pockets.

Currently, traditional manned surveillance is the mainstay. Often, the investigative objectives of claim handlers exceed the physical abilities of investigators or geographic locations of desired surveillance. Specific examples include long-term, covert surveillance assignments that require hundreds of hours of continuous video documentation, which could be conducted in 100-plus-degree temperatures. In some cases, inhospitable locations or environments might compromise and investigator or put him into danger.

Remote surveillance uses unmanned vehicles that are deployed in the proximity of desired surveillance locations. These specially equipped and outfitted vehicles host a variety of electronics, including concealed video cameras. Encrypted and secured wireless links allow investigators to manipulate and control the on-board video cameras and surveillance systems from any geographic location. Remote surveillance may be conducted in Atlanta, while being controlled and monitored from Miami.

Endless Possibilities

Every investigation is different and, thus, requires unique investigative techniques that assist in evaluating the legitimacy of a particular claim. Over a five-day period, between the hours of 7:00 am and 8:00 pm, 65 hours worth of remote surveillance can be conducted, documenting all the activities occurring at the claimant's residence. The video results are reviewed, which results in better future scheduling of traditional surveillance, increasing positive surveillance results.

Unmanned remote surveillance also can provide a clear record of the frequency and duration of care attendants' visits. With consecutive days of continuous 24-hour covert surveillance at claimants' residences, the presence of attendant care providers can be documented and timed.

Remote surveillance also can provide a video record of the actual activities at a claimant's home for an entire week. Questions such as, “Who is mowing the lawn?” and “Does the claimant ever leave the house?” can be definitively answered and documented.

When investigating suspected fraud by medical-care providers, unmanned remote surveillance is conducted for five consecutive days at a clinic location, documenting every individual entering and exiting from a single entrance point. The video is later reviewed against the patient, treatment, and procedure logs to determine whether the clinic's medical billing practices are accurate and consistent.

In rural areas, unmanned vehicles can maintain surveillance from locations otherwise considered unfeasible. Suspicions and investigator risk are greatly minimized. Unmanned remote surveillance also is ideal for cases requiring long-term surveillance documentation, such as job sites, construction locations, or other employment-related activities.

The complexity and sophistication of questionable claims is a growing challenge and concern for the insurance industry. Claimant fraud, provider fraud, and other criminal enterprises involving insurance fraud are considered one of the nation's most serious domestic issues.

Effective fraud management is one of the fundamentals required for good claim adjusting. This includes honest, ethical, and legal outside investigations conducted by licensed investigators.

Surveillance long has been recognized as an effective tool within the claim industry. Used to help better identify, recognize, and document questionable bodily injury claims, surveillance must continue to be employed wisely to mitigate suspected claims. With the technology currently available, unmanned remote surveillance is quickly finding its place within the insurance claim community.

Stephen Cassell is president of RSight Investigations.