Insurance Fraud & Risk Management Investigation

Investigations of Fraudulent Insurance Claims

Corporate Investigations of insurance fraud was once thought to be very uncommon. Who would commit fraud against their employer or insurance companies? Now the cost to consumers is staggering and each fraud claim not only an adverse effect on the economy but consumers as well.

However, as employees become more desperate to reach a work-life balance this scheme can easily be started and manipulated for years.

For example take the case of “John Smith” a fictitious character. John is a 22 year-old college student. John had ACL surgery after an athletic accident. Months after his surgery he claimed the physician improperly performed the surgery and could not recover as expected. Soon thereafter, Mr. Smith filed a lawsuit against the physician and informed his employer he could no longer work.

Mr. Smith’s extensive long-term injuries were disproven merely by three days of factual footage taken by investigators at LII.

Injury fraud cases like the one above often times can suddenly place a physician, employer, and insurance companies in complicated position as whether to avoid litigation or hire a team of investigators to disprove the injury and scheme. Payouts on claims like this can be thousands and ongoing for years, forking out huge retainers to lawyers and experts.

Unfortunately, the only way to disprove the scheme is a successful pictorial or video of the subject. Success to disprove insurance fraud and minimize impact depend on a two-fold approach, a sequential “truth video” and an investigative team with strong testimony skills.

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