These days, disability benefits fraud is a hot topic. With COVID-19 disrupting so much of our daily life, it’s easy for fraudsters to slip between the cracks. The good news is, insurance companies spend a lot of time working with private investigators to make sure that benefits get to the right people. Keep reading to find out more about disability benefits fraud and how private investigators use surveillance to help insurance companies catch a criminal.
What is Disability Benefits Fraud?
Disability benefits fraud occurs when an individual lies about an injury and makes a claim with an insurance company. Here’s an example: let’s say that an employee in a warehouse is using a forklift. They move some skids, one falls, and some product breaks the employee’s arm. The accident is covered by the company’s insurance. The employee will also receive disability benefits (or paid time off work) to recover. This financial assistance is typically a percentage of their usual pay. Disability benefits fraud occurs when an employee’s injuries heal, but they continue to make insurance claims and/or don’t go back to work.
On the Rise in Canada: Disability Benefits Fraud
COVID-19 is having a drastic impact on many people all across the country. Through Canadian government support, many people can receive CERB. In Canada, CERB is a benefit that helps to bridge the gap of unemployment until it is safe to return to work. There are, however, some people that apply for CERB (and other benefits) even when they aren’t eligible. Unfortunately, during these challenging times, some people also continue to make disability claims, even though they are ready to go back to work.
According to the Kingston WHIG Standard, insurance companies across Canada are investigating disability benefit claims. The reason for this due to the sheer number of people who have made benefit claims over the past four months. The cost of so many claims will inevitably have an impact on the financial stability of insurance companies. Therefore, it is in the insurance company’s best interest to confirm the validity of all claims.
Why Insurance Systems Hire Private Investigators
To help with disability benefits fraud, insurance companies often work with private investigators. There are many reasons for this including,
Private Investigator Skill Set
One of the main reasons why insurance companies hire a private investigator or private investigation agency is because private investigators have the right skills to get the job done. Insurance agents might receive a tip or suspect that an individual is making a fraudulent claim, but they don’t have the right skill set to get proof. This isn’t to say that an insurance agent wouldn’t make a good private investigator! However, they lack the training that a private investigator earns when they receive their license.
The Time
Insurance agents don’t have the time to investigate every insurance fraud claim that comes across their desk. The reason for this is because he or she is busy trying to get their job done. They don’t have time to check in on clients. Sending insurance agents out to check up on people is also an inefficient use of their time. Hiring a private investigator puts the legwork into someone else’s hands. The benefit here is that a private investigator can investigate an individual quickly to determine whether or not an insurance agent should take action or not.
Gathering the Right Evidence
As mentioned, insurance agents aren’t trained in private investigation techniques. Most people don’t know how to legally gather evidence either. So, why should an insurance agent be expected to gather evidence and proof about an individual making false benefit claims? Hiring a private investigator ensures that the right kind of evidence is collected and gathered. A private investigator will put together a comprehensive report that the insurance company can then use in court. This is the goal in a fraudulent benefits case, to stop an individual from abusing the system so that people who genuinely need it, receive the right help.
What is Surveillance?
Surveillance is a method of private investigation. It is the art of watching or monitoring an individual to gather information about their daily activities. A private investigator will want to run a successful surveillance operation. It is absolutely critical that the individual doesn’t spot the private investigator. The reason for this is because an individual will change their behaviour the minute they think someone is watching. When it comes to disability benefit fraud, for example, an individual will behave differently if they think they’ll get caught doing heavy labour like laying brick or building a new deck. This is why it’s so important to hire a private investigator. They have the right skills and time to gather the right evidence.
Private Investigators, Fraud and Surveillance
A private investigator will use surveillance to monitor an individual. The reason for this is because the insurance company will need proof that the individual is not injured and doesn’t require disability benefits. Surveillance operations will help to gather that type of evidence.
Depending on the situation, the private investigator will set up surveillance in a couple of different ways. The most common include:
Surveillance from a Vehicle
A private investigator will use a vehicle to run surveillance on an individual. The private investigator will park the vehicle at a discreet distance and watch the individual when they are at home. If the individual leaves home, the private investigator will tail them until they reach their destination. In some cases, a private investigator will work with other private investigators to make sure they have eyes on the individual at all times.
Surveillance on Foot
If the individual goes anywhere on foot, a private investigator will follow. According to the article written by the Kingston WHIG Standard, private investigators have even pretended to join a gym to capture evidence against someone making a fraudulent benefit claim. A private investigator can still run surveillance on foot, they just need to be very careful not to let the suspect catch them in the act.
Insurance Fraud Penalties & Fines
Let’s say that a private investigator runs surveillance on an individual. Through the investigation, the private investigator discovers the individual’s injuries have healed. The insurance company will receive a report from the private investigator with evidence and other proof. The insurance company can then charge the individual and even take them to court. Fines can run up to $50,000 (or double the amount of the fraud) and include between 3 to 5 years of jail time.
It is important to understand that an insurance company will not hire a private investigator to monitor you without reason. Good private investigators also do not make up evidence just to try and prove that an individual is lying. If you have made a genuine disability benefits claim, you have nothing to fear.
Need help with disability benefits fraud? Do you need help with surveillance? You’ve come to the right place! Contact us today to speak with one of our highly trained private investigators.
Email: Info@TheSmithInvestigationAgency.com or Phone: (888) 950-4113
About the Author
Whitney Joy Smith
Founder of The Smith Investigation Agency in 2014, Whitney Joy Smith’s extensive background as a private investigator is matched only by her passion for the role. A graduate of several respected institutions, including Northwest Florida State College and George Brown College, her early years in life were spent between Canada and the United States. This education, along with her formative years as a private investigator in various agencies, informed much of her knowledge of private investigative laws, regulations, and operating standards in both countries.
The recipient of numerous industry awards and accolades, including the Consumers Choice Award, Best in Ottawa, and many others, Whitney takes pride in working closely with her ever-growing agency to raise the bar, maintain compliance, and meet the investigative needs of clients. Whitney is active in various membership and supporting roles, including the CPIRC, CBN, CAPI, Canadian Women’s Chamber of Commerce, and many others. Her experience-driven, thought-provoking articles have been featured in everything from Readers Digest to Business News Daily, and she strives to continually redefine standards for those in the private investigative and security fields. Learn more about Whitney and the team at The Smith Investigation Agency today.
