Howard Goldblatt, director of government affairs for the Coalition Against Insurance Fraud and contributor to their Insurance FraudBlog, posted that several states are cracking down on drivers who falsely register their vehicles in states with lower car insurance premiums.
There will always be a select group of individuals that cheat the system, and the auto-insurance system is no exception. These rate evaders typically don’t drive or live in the states that their vehicles are registered in. And even though not all states and/or jurisdictions recognize rate evading as insurance fraud, the following states/jurisdictions have decided that enforcement is necessary to combat insurance crimes and keep premiums lower for drivers:
Philadelphia/Pennsylvania: According to Goldblatt, “Years ago the then-Philadelphia DA offered amnesty for dishonest drivers to step forward and properly register their vehicles in Philadelphia instead of their falsely claimed addresses in the Philly suburbs or southern New Jersey. A number of folks set their registration record straight – including an employee in the DA’s office.”
North Carolina: More recently, the state identified that out-of-state drivers were registering their vehicles in-state. To crack down on rate evaders, North Carolina changed their policies when registering and insuring vehicles to require drivers to show proof of residence.
New Jersey: Just weeks ago, a bill was passed by the New Jersey Assembly to crack down on drivers lying about where they store or garage their vehicles. If the bill becomes law, more authority would be granted to the state to target these individuals.
New York: Drivers in New York are raising insurance risks and premiums for the state that they are falsely registering their vehicles in, without lowering insurance risks in their own state. How?
According to Goldblatt, “New York has seen insurance investigators, consumer and community groups identify numerous suspicious vehicles parked in residential neighborhoods in Staten Island and Brooklyn. The vehicles oddly had license plates from Virginia, North Carolina, Pennsylvania and Iowa. Visiting friends or relatives don’t own these vehicles. They’re driven by New Yorkers who are cheating the insurance system.”
A bill is in the works in Albany, New York to make false vehicle registering a crime in the state.
If a claimant has a LinkedIn profile, it’s obviously a fairly easy avenue to develop employment information. LinkedIn’s social platform is meant to connect professionals to one another, whether by industry, geographical area, company, among other criteria. LinkedIn also allows job postings, and attracts many professionals who are looking for work. And for that reason, many users choose to leave their profiles public in hopes of attracting more traffic by potential employers and creating connections (side note: you don’t have to be logged in to LinkedIn to see a public profile). But employment is not the only piece of information to be discovered through this social platform. Take a look at the example below:
Without even being logged in, we just found out where he works, where he interned, a general area where he may live, most of his previous jobs, where he went to college, the type of degree, and that his interests include staying active (possibly working out) with soccer, sports, etc.
Now, we are able to take all of this information, use it to develop the rest of his social media accounts, and run with it. It is people like this individual that make our jobs a tiny bit easier; the people who are willing to share their entire lives with the rest of the world.
As we all know, surveillance is not what it used to be. Gone are the days that we receive an assignment and start blind.
With all of the resources available to us at our fingertips or with the click of a button, we enhance our ability to locate, investigate and profile claimants to ensure a cost-effective investigation.
The pre-surveillance work conducted before embarking on every surveillance assignment and the techniques used to profile claimants have given us new direction and a starting point that was not available just a few years ago.
Surveillance 101 starts with PREPARATION and PLANNING. The ICU staff takes advantage of all information developed through social media, proprietary databases, location scans, etc., prior to heading out on an assignment.
Investigators must have a solid plan to approach each individual surveillance assignment to maximize results. No two surveillance assignments are alike, just like no two claimants are alike. The characteristics of each individual vary greatly, and planning around a work or school schedule, alleged injuries, where they live, age, relationships, modes of transportation, etc. are all taken into consideration.
Once on-site, the plan must be refined according to the environment. How close are the claimants to any subways or bus stops? Are there additional, unknown vehicles in the driveway? Can you see the house from the street and/or established surveillance position? Can you park on the street anywhere near the home safely or undetected? How many exits does the building have? The list goes on and on.
However, even with all of the resources that ICU has grown with and adapted to, there are some things that you just cannot teach. It takes a special kind of person to conduct surveillance (and truthfully, to conduct any investigation, internally or in the field). Let’s face it; not everyone is cut out for this type of work. Investigators must have the following:
Patience – In each interview process, investigators are asked if they like fishing. If they hate it, they can’t be a surveillance investigator. And why is that? Because it’s all about a waiting game. Investigators spend upwards of 8-12 hours in a vehicle waiting for just one glimpse of a claimant. If you don’t have the patience for it, you will not succeed.
Focus – Maintaining your focus throughout the course of a surveillance assignment is paramount. It only takes a second for a door to open and close. Much can be learned or lost in that moment.
Tenacity – You must be tenacious day in and day out to constantly acquire video on your clients’ behalf. The environment, weather and location of the surveillance are constantly changing from moment to moment, place to place. There are a multitude of outside factors trying to prevent you from acquiring great video – whether it is traffic, a school bus, a traffic cop, a nosy neighbor, a busy parking lot, a crowded subway or an empty subway. You must be tenacious through it all and press on, undetected, to get great video…and we do.
THAT is why we are so selective and meticulous in our hiring process. We vow to provide our clients with quality work, accompanied by unparalleled customer service, and we won’t settle for anything less.
OPRA requests are one of the best tools the public has to obtain government information on a state, county, or municipal level. This New Jersey law is often overlooked as a means to collect public information, but the New Jersey Open Public Records Act mandates that the public agency produces the record requested within seven business days of receiving the request.
We can request records from specific departments (then an agency within that department) such as:
- Banking and insurance
- Children and families
- Civil service commission
- Commissions and agencies
- Community affairs
- Environmental protection
- Office of Governor
- Human Services
- Law and public safety
- Military and veterans affairs
- And many more!
It is important to remember that some records are exempt from disclosure. Exempt records are listed below:
- Criminal Investigation Records
- Records relating to an ongoing investigation
- Personnel/pension records (with some exceptions)
- Inter- or intra-agency advisory
- Consultative or deliberative material (drafts of documents)
- Records protected by court order
- Records protected by attorney-client privilege
- Job applicant records
- Fingerprint cards
- Illegitimacy records
- Records that would substantially impair the state’s ability to defend against sabotage or terrorism
- Legislative records
- Medical examiner records
- Victims’ records
- Trade secrets and proprietary commercial or financial information
- Administrative or technical information regarding computer hardware, software and networks which, if disclosed would jeopardize computer security
- Emergency or security information or procedures for buildings or facilities which, if disclosed, would jeopardize security of the building or facility or persons therein
- Security measures and surveillance techniques which, if disclosed, would create a risk to the safety or persons, property, electronic data or software
- Information which, if disclosed, would give an advantage to competitors or bidders.
- Information generated by or on behalf of public employers or public employees in connection with:
- Any sexual harassment complain filed with a public employer
- Any grievance filed by or against an individual
- Collective negotiations including documents and statement of strategy o0r negotiating position
- Information which is a communication between a public agency and its insurance carrier, administrative service organization or risk management office
- Certificate of honorable discharge issued by the US government filed with a public agency
- Personal identifying information (social security numbers, credit card numbers, unlisted telephone numbers, drivers’ license numbers)
- Certain records of higher education institutions (academic research records, test questions/scoring keys/etc)
- Biotechnology trade secrets
- Limitations to convicts – personal information pertaining to the person’s victim or the victim’s family, including but not limited to a victim’s home address, home telephone number, work or school address, work telephone number, social security account number, medical history or any other identifying information
- Public defender records that relate to the handling of any case
- Privacy Interest – “a public agency has a responsibility and an obligation to safeguard from public access a citizen’s personal information with which it has been entrusted when disclosure thereof would violate the citizen’s reasonable expectation of privacy.”
We found an article that pretty much sums up what we do on a daily basis to build an internet profile report for our clients. Not only does this illustrate perfectly how we build the bigger picture for you, but it also demonstrates the rewards (and potential harm) that social media has in our daily lives.
Joe Stephenson of PropertyCasualty360 tells the story of his walk around CalTech campus located in Pasadena, California where he stumbled upon a college ID on the ground. With limited time to try to locate the ID’s owner, and realizing that the ID actually belonged to a student at another local college, he figured he could conduct a little search to try and develop an address so he could politely drop the lost ID in the mail and it would find its way home in the student’s mailbox.
But what Joe Stephenson found was not what he was expecting. This girl’s entire life was plastered all over the internet.
“Mind you, this is a very bright and intelligent young woman, but like most her age she lacks a clear understanding of how the internet can be used – and this is from someone who has been essentially raised during this technological age. Good for those of us fighting evil but bad, very bad, when evil is searching for a target,” proclaims Stephenson.
By conducting one quick Google search on his PHONE (no utilization of databases or paid sites), using the only information that he knew about her (her name, the college she attends, and her picture), Joe uncovered the following information about the unsuspecting student:
Her studies: projected graduation year, her approximate age, what she studied, who her professor was, where she would likely be on campus, and more photos. He knew her aspirations, future projects, and read a technical paper she wrote. Ok…some basic research, but a bunch of new avenues to explore.
After that quick Google search which uncovered some unique photos of the student, Stephenson took to the Images tab in Google and found:
She likes yoga (he was able to see where and what time), she likes beer, prefers dogs over cats, prefers a specific airline, she is from a city in Northern California, she was the editor of her high school yearbook in said city, she lived locally, and she owned a Prius and/or a Honda (both license plates were pictured in a photo).
She had just returned from a trip to Australia this past July (specifically in Sydney, Australia on July 5th).
She also included a picture of her drivers license in one of the photos she posted!
Stephenson said, “California is one of the strictest states regarding the disclosure of DMV data and PII (Personally Identifiable Information) and this young woman is giving it away to everyone! I didn’t have a specific physical address, but I did have her name, date of birth, driver’s license number, school information, vehicle info, hometown and high school. Finding her mother’s maiden name would only have been a few more clicks away and then I’m making my own Visa cards! Skip going to her home and breaking in and risk getting caught – this guy just became an identity thief!”
We apply these techniques to our claims investigations every day. And as scary as it may be, there are people out there who don’t realize how dangerous it may be to post their personal information online and on social media…but they do it anyway (good for us). If the information is out there, we will find it!
Stephenson could not have wrapped this article up with a better statement: “Take what you want from this research example, but do not ignore the importance of using the internet or making it a mandatory resource during investigations.”
According to Kathleen Hopkins of the Asbury Park Press, 40-year-old Middletown resident, Donna Dzienisewski, plead guilty to healthcare claims fraud last month, admitting that she submitted over $500,000 in fraudulent insurance claims for medical procedures she never received.
Acting Attorney General John J. Hoffman and acting Insurance Fraud Prosecutor Ronald Chillemi stated in a news release that Dzienisewski admitted to Superior Court Judge Anthony J. Mellaci Jr. that between March 18, 2011 and March 12, 2013, 107 claims were submitted to Horizon Blue Cross Blue Shield of New Jersey for approximately $502,740 in healthcare expenses, including 107 doctor visits.
However, an investigation launched after Dzienisewski was paid $141,126 by HBCBS of NJ. As the rest of her claims were pending, investigators determined that she had only incurred six doctor visits between March 18, 2011 and March 12, 2013. The expenses for those visits should have totaled $2,640, according to the news release. But for those particular visits, Dzienisewski claimed the expenses totaled $8,640.
The sentencing hearing is scheduled for February 6, 2015. Dzienisewski’s plea deal saved her from spending up to 10 years in prison. As part of the plea bargain, the state will recommend a five-year sentence, repayment of $10,000 in restitution, and a civil consent judgment totaling $50,000.
Since most of the money Dzienisewski collected from the insurer has been spent, the civil consent judgment will place a lien on her assets and will ensure that if she ever stumbles upon some money, it can be recovered.