With decades of combined experience in the insurance investigations industry, Diligence International Group has developed strategic surveillance methods that lend a unique perspective to fraud detection. Today, those methods have allowed us to proceed with our surveillance assignments despite the various lockdown and social-distancing measures implemented across the country due to COVID-19.  

We know it is crucial for our clients to stay up to date on the latest trends and we want to provide you a snapshot of what we have seen over the past month with regard to surveillance conditions during COVID-19, and some recommendations for moving forward.

Diligence believes the initial stages of an investigation often determine the ultimate outcome. Through a detailed surveillance analysis at the onset, we are able to verify the subject’s identity and confirm vehicle association to lay the foundation of the case. Typically, this stage is the most difficult as subjects are oftentimes away from their homes. However, given that most states are under stay-at-home orders, we have noted that this may be an opportune time to conduct a thorough pre-surveillance on any potential investigation being contemplated in the near future. Pre-Surveillance is not just economical, it is a valuable and informative tool.

As widely noted throughout the industry, we have observed many more subjects active near their residence, as opposed to going about their daily routines away from their homes. We have seen a significant increase in subject-related activities around residences such as doing chores, doing yard work, working on vehicles, taking long walks and engaging in many other activities. This increased activity has presented a perfect opportunity to monitor claimants during this period as COVID-19 has had a perceived notion that claimants will not be active during the stay-at-home period. 

We are also seeing a trend in malingering among claimants, even more so during this pandemic. Given these findings, evidence in the form of video footage greatly complements data research. 

As many individuals are now out of work as a result of the stay-at-home orders, we anticipate a surge in questionable claims once the pandemic begins to abate and states relax restrictions. We are finding that now is the best time to conduct pre-surveillance and research against potential fraudulent claims and begin laying the foundation for the best course of action. It is best to probe now and prevent small claims from snowballing out of control.

Here are a few key takeaways from what we’ve identified regarding surveillance during COVID-19:

Surveillance continues as investigators can conduct investigations safely as they mostly remain restricted to their vehicles.

In undercover situations, investigators are practicing all CDC recommended actions including wearing face masks and practicing safe social distancing.

Specific to Long Term Care, COVID-19 or not, care requirements do not fluctuate, and care should be provided as usual. In the instance normal care providers are not showing up due to health concerns, family members or close associates providing care should be documented. Scrutinize bills for care to see if fluctuations in billing have occurred (or not) since the crisis, to detect potentially fraudulent activity.

As evaluations and IMEs go virtual, surveillance should still be conducted around the surrounding days to corroborate the details from the exam.

Use this period as an opportunity to lay the groundwork for future investigations by obtaining positive subject identification and documenting household vehicles while people remain mostly confined to their homes.

Work closely with data and social media investigations as subjects tend to be increasing the utilization of social media at home. Our in-house team is skilled at conducting background research, monitoring social media and using resources to conduct initial due diligence.  

We have observed that individuals who have been inactive on social media in the past, are using social media platforms now more than ever. 

Use this time to get in touch with claimants to see how things are progressing and how they are doing during the pandemic. Narrowed questions may be used to detect potential questionable activity. 

At Diligence, we always advocate for ‘intel gathering’ knowing that the more information available up front, the better results overall.

Although many companies have decided against conducting surveillance during this time, based on our recent results, we are finding this to be an exceptional time to accurately detect any level of activity while most people are confined to their homes. We are also using this time to prepare and plan for any future claims by leading the way with dynamic investigation methods through advanced technology. 

At Diligence, we continually work on solutions that best fit our clients’ unique needs and interests. Working outside the box to achieve maximum results has always been our top priority and continues to drive our mission.

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Investigating during COVID-19: The same, but different
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