Insurance fraud is a pervasive issue that costs the industry billions of dollars annually. As fraudsters become more sophisticated, so too must the methods used to detect and prevent fraudulent claims. One of the most effective tools in this fight is social media investigations. At True People Check, we specialize in leveraging social media to uncover inconsistencies, expose false claims, and provide insurers with the evidence they need to combat fraud.
In this blog, we’ll dive into real-life case studies that demonstrate how social media investigations have been instrumental in uncovering insurance fraud. These examples highlight the power of social media as a tool for truth-seeking and fraud prevention.
Case Study 1: The Marathon Runner
The Claim
An individual filed a claim for workers’ compensation, stating they had suffered a severe back injury that left them unable to work or engage in physical activities. They claimed the injury occurred while lifting heavy equipment on the job.
The Investigation
Our team at True People Check conducted a thorough social media investigation, scouring the claimant’s public profiles for any signs of activity that contradicted their claims.
The Findings
Just two weeks after the alleged injury, the claimant posted photos and videos of themselves participating in a local marathon. Not only were they running, but they also shared a celebratory post about completing the race with a personal best time.
The Outcome
The evidence gathered through the social media investigation was presented to the insurer, who used it to deny the fraudulent claim. This saved the company tens of thousands of dollars in payouts.
Case Study 2: The Jiu Jitsu Athlete
The Claim
An employee filed a workers’ compensation claim, alleging they had suffered a debilitating neck injury while on the job. They claimed the injury left them unable to perform basic tasks or engage in physical activities.
The Investigation
Our team at True People Check initiated a social media investigation, focusing on the claimant’s online activity and connections. We also expanded our search to include local businesses and organizations they might be associated with.
The Findings
Through our investigation, we discovered that the claimant was an active member of a local Jiu Jitsu academy. The academy’s social media accounts featured photos and videos of the claimant participating in grappling sessions and training exercises. Notably, the claimant appeared to move without any restrictions, contradicting their reported injury.
The Outcome
The insurer used the evidence from the social media investigation to deny the fraudulent claim. The claimant’s active participation in Jiu Jitsu, as documented on the academy’s social media, clearly contradicted their reported condition.
Case Study 3: The “Homebound” Injury Victim
The Claim
An individual filed a disability claim, stating they were homebound due to a severe leg injury sustained in a car accident. They claimed they were unable to walk without assistance and required constant care.
The Investigation
Our team conducted a social media investigation, examining the claimant’s profiles for any activity that contradicted their reported condition.
The Findings
The claimant’s social media accounts were filled with posts showing them at various social events, including concerts, restaurants, and even a hiking trip. Photos and check-ins revealed they were not only mobile but also engaging in physically demanding activities.
The Outcome
The insurer used the evidence from the social media investigation to deny the fraudulent claim. The claimant’s online activity clearly contradicted their reported injuries, saving the insurer from a significant payout.
Case Study 4: The Active DJ
The Claim
A subject was out on workers’ compensation, stating they had suffered a back injury that left them unable to work or engage in physical activities.
The Investigation
Our team at True People Check conducted a social media investigation, examining the claimant’s online activity for any signs of physical activity that contradicted their reported injury.
The Findings
The investigation revealed that the claimant was far from homebound. Their social media profiles were filled with posts showing them DJ’ing at clubs, and dancing energetically. Additionally, the claimant frequently posted about their fitness regimen at the gym, including photos and videos of them lifting weights. We were able to identify the gym the subject was going to, which led to a successful surveillance investigation.
The Outcome
The insurer used the evidence from the social media investigation to terminate ongoing benefits. The claimant’s active lifestyle, as documented on social media, directly contradicted their reported injuries.
Conclusion
Insurance fraud is a costly problem, but social media investigations offer a powerful solution. By leveraging the wealth of information available on social media platforms, investigators can uncover the truth and protect insurers from fraudulent claims.
If you’re an insurance company looking to enhance your fraud detection capabilities, True People Check is here to help. Contact us today to learn more about our social media investigation services and how we can assist you in combating fraud.
