It’s Monday morning
and Jeremy McFadden, a fraud
program specialist at Erie Insurance, is surfing
Facebook.
Jeremy isn’t reliving
memories from the weekend—he’s knee deep in investigative work that saves ERIE
and its Customers many thousands of dollars every year.
“Though the vast
majority of claims are legitimately submitted by honest people, there is a
small portion that requires further review,” says Gene Robertson, director of
Special Investigation and Analysis at ERIE. “Social media is absolutely helping
us do that.”
Insurance fraud cases
Insurance
fraud is a serious crime in
which someone knowingly and intentionally sets out to deceive their insurance
company. It is different from an innocent misrepresentation in which someone
unknowingly presents false information to their insurer. (For instance, a fire
destroys an appliance and someone overestimates how much it cost because he
lacks a receipt.)
Circumstances
surrounding suspected fraud tend to be highly unusual. “There is a big red flag
when truly fraudulent activity occurs,” says Gene. Insurance fraud is a crime
in every state—and in most cases, it’s a felony.
Insurance fraud cases end up costing Customers
The property and
casualty insurance industry estimates that fraud costs between $30 and $60
billion a year. Insurance fraud is the second most expensive white-collar crime
after tax evasion—and it costs honest Customers, who eventually foot the bill
in the form of higher premiums.
Today, more people are
making this connection. “Thanks to successful advertising and public awareness
campaigns over the years, the way the public views insurance fraud has really
changed,” says Frank Scafidi, director of public affairs at the National
Insurance Crime Bureau (NICB), a not-for-profit organization that partners with
insurance companies like ERIE and law enforcement agencies to fight insurance
fraud.
“People used to brag
about getting one over on insurance companies, but there’s now a realization
that this causes your friends and family to pay more,” he says.
Piecing it all together
ERIE fights insurance
fraud cases on many fronts. There’s old-fashioned detective work like visiting
premises, conducting interviews and acting on tips. ERIE also uses
sophisticated software and collaborates with the NICB, law enforcement and
other insurers.
Fraud investigation is
about seeing the whole picture, and social media posts, photos and videos are
increasingly a part of that picture. This doesn’t mean all information is free
game. ERIE respects Customers’ privacy rights by only looking at publicly
available information. That means ERIE investigators will never create fake
profiles to “friend” or “follow” a Customer with a suspicious claim.
“Our whole premise at
ERIE is about doing the right thing,” says Robertson. “Protecting and
respecting our Customers’ privacy is a priority in all we do, including our
investigative work.”
Fortunately, such
measures usually aren’t needed.
“What we find is that
fraudsters often neglect to cover their tracks,” continues Robertson. “Even if
their profile is private, they often post to pages of friends and groups whose
accounts are public.”
A few recent insurance fraud cases
Just a few instances
in which information gleaned from social media played an important role in
unraveling insurance fraud cases included:
• The Playground Scam:
A claim was filed for a playground that was allegedly damaged beyond repair in
a storm. The playground was disposed of, leaving ERIE no way of verifying the
claim. A few weeks later, the claimant was selling the same playground on
Facebook.
• The Tractor Pull
Scam: A claim was filed alleging an engine was damaged when someone put the
wrong fuel in it. ERIE later found a YouTube clip and Facebook photos of the
claimant participating in a tractor pull in the same truck. ERIE personal auto
policies exclude coverage while participating in organized racing, high
performance driving, stunting and similar sporting events.
• The Livery Van Scam:
Several people simultaneously filed claims to an ERIE personal auto policy.
ERIE later discovered a Facebook page advertising the claimant’s van as a
public transportation business. ERIE personal auto policies exclude
transporting people or goods for hire.
ERIE investigators
have also unearthed many online photos and comments implicating claimants of
committing workers’ compensation fraud. “I’ve seen claimants who are ‘too hurt
to work’ post updates about their marathon training schedules or photos of
themselves backpacking through the mountains,” says McFadden.
When ERIE presents
someone with solid evidence of fraud, most people will withdraw or stop
pursuing a claim. ERIE then turns things over to law enforcement, who will
decide how to handle the crime.
You can help ERIE fight fraud
Though social media is
playing an increasingly important role in combating fraud, your input still
matters.
If you suspect that
someone is committing insurance fraud, let ERIE know by calling the toll-free
Fraud Hotline at 800-368-6696 or emailing fraud.finders@erieinsurance.com.
Together, we can reduce this costly crime.
No comments:
Post a Comment