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Volume 6, Issue 4
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(323) 275-2100 | Busted@dmaclaims.com | www.dmainvest.com
 
 
BUSTED: Victories for Truth, Justice, and Lower Insurance Premiums
 
The Perils of Car Maintenance
 
By a DMA Investigator
 
Normally car maintenance is an activity that is good for morale and poses no threat to the individual providing care for his or her equipment. But a person claiming disability and attempting to collect Workers Comp benefits ought to know better than to clean a car, increase tire pressure, open and close garages and perform similar tasks. The potential of a large "gift" from Workers' Compensation would incline the truly devious person to require such tasks to be performed by a spouse, a "significant other" or a hired hand.

Our subject claimed left arm, left leg and back injuries and was collecting benefits. She was reportedly using a cane. The assignment was for two days of surveillance.

The subject's residence was one of ten units, not visible from the street. But the garage was right on the street and it turned out that our subject felt strongly in matters of vehicle maintenance. We were able to obtain footage of her checking air in all 4 tires, using a pump to add air to all 4 tires, and then washing the car. Or to be more accurate - the mini van. The stretching and contortions necessary to clean the roof of a mini van when you are 5 foot one inch tall require more than an absence of disability - true dexterity and great balance are a vital necessity. Needless to say, all this involves a lot of bending, crouching, twisting, stretching, use of the left arm in lifting, etc. No sign of hesitation or pain. Not a cane in sight.

 
Next we were instructed to get film of the subject's arrival at the Workers Compensation Appeals Board, her departure from home prior and her arrival at home afterward. She left home without a cane, walking with no sign of pain. She arrived at the hearing and the cane came out of the trunk of the car. In all the time we had observed her, this was the first instance of the cane. Her gait for the first time developed a slight hesitation. But all that was short-lived. By the time she was home she was feeling fine, the cane went back in the trunk and she walked into her residence with ease.

Our subject was playing hardball and took this to trial before the Workers Comp Appeal Board. But when her attorney viewed the film, the matter settled for a fraction of the demand, saving tens of thousands of dollars.

   
     

 

FRAUD CHRONICLES – Tales from the Front Lines

Insurance fraud is a significant factor in insurance costs. Estimates of insurance premium devoted to paying fraudulent claims range from 5% to 30% and any of these percentages translate into billions of dollars lost.

The front line in the fight against many types of insurance fraud is the field investigator, armed with digital camcorder and telescopic lens. Here is where the truth as to physical condition and claimed disability can be found.

To obtain a copy of Fraud Chronicles: Tales from the Front Lines, please go to the following URL: http://www.dmainvest.com/fraudchronicles

 

 
WORKERS' COMP NEWS
 
Stripper faces trial over workers' comp claim
 
By Scott Kraus, OF THE MORNING CALL
For the full article, click here.
 
 
     
THE LEGAL ARENA
 
Fighting fraud: Link between bogus insurance claims, recession is murky
By Katy Stech - The Post and Courier
For the full article, click here.
     
     
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