The Fraud Chronicles 2: You Insulted My Equipment!

When someone commits insurance fraud, such as claiming to be injured or disabled from a work-related incident when they are not, honest people suffer through higher insurance premiums. 25% of all insurance premiums go to pay for fraudulent claims, just so some bad guys can live the high life and avoid working.

But DMA Claims Services (http://www.dmaclaims.com/investigations.shtml) is fighting the bad guys one at a time by investigating, conducting surveillance, and if their claim is found to be fraudulent, busting them! And when that happens, everybody wins - except for the bad guys of course. No more high life for them.

This is a case from the DMA Investigations archives, Part 2 of the Fraud Chronicles.

What Did You Say About My Overhead Projector?
By Jim Smith,
Deputy Director, DMA Investigations

"There was a male claimant who worked in the audio/visual department of a large teaching hospital. For a year this man kept a secret diary of any and all negative comments made by his co-workers regarding the audio/visual equipment used at the hospital.

"After a year of keeping his secret diary of these negative comments, the man filed a 'stress' claim due to the nature of the comments made by his co-workers. He claimed that these negative comments had caused irreparable harm to his psyche, and that as a result he had suffered an inability to work or function in any workplace or common social situation.

"Surveillance was approved on the case, just to see how badly Mr. Audio/Visual's psyche was damaged, and to see if we might find him frequenting any workplaces or social situations.

"Upon conducting surveillance, it was noticed the claimant's vehicle never left the curb in front of his house, and was always there during normal working hours. I then began checking at odd hours, but again the vehicle was always at the residence. Eventually the file was closed, as it appeared Mr. A/V truly was not active.

"Having had my curiosity piqued, and even though the file was closed, I would occasionally go by Mr. A/V's residence just to see if anything new was happening. One day I went by and there was a parking stub under the car's windshield wiper. I checked it and noticed that Mr. A/V had been parking in a lot in downtown LA, at a very early hour.

"I then called and received authorization to reopen the investigation. The next morning at 1 a.m., I began following the claimant into downtown LA. This was a bit dicey, as once we got into the downtown area, ours were literally the only vehicles on the street. I turned off, watched his vehicle until he parked, parked my car, then ran to catch up with him on foot. I grabbed my briefcase off the seat, to at least give me some "cover" as I walked through the streets at this early hour.

"I tailed my subject on foot for several blocks. We ended up going into Parker Center, the Los Angeles Police Department Command Center, right at shift change. I acted as though I belonged, and continued following my subject.

"Ultimately I tailed him to their Photo Lab where he disappeared and, not having access, I ended off.

"Shortly thereafter I was able to learn that Mr. A/V had now become Mr. CSI Photo Man. He had recently gone to work for the LAPD as a crime scene photographer on the graveyard shift, which explained why he had appeared inactive initially.

"Taking a job while receiving disability payments is a greater offense than disparaging overhead projectors, as our claimant and his attorney soon found out."

Another victory for truth, justice, and lower insurance premiums.

Tom Reitze is President of DMA Claims Services (www.dmaclaims.com), an independent claims adjusting and investigations company with 42 offices in 16 states.

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