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Using social media to keep eye on fraud

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Looking through social media is an emerging and vital surveillance strategy for insurance companies wishing to investigate potential fraud, said a speaker at a session on advanced strategies in surveillance at the Risk & Insurance Management Society Inc.'s conference Tuesday in San Diego.

“It's fundamental we investigate social media,” said Steve Cassell, Lake Mary, Florida-based president and CEO of Command Investigations L.L.C. “It can't be overlooked or ignored.”

With 80% of people age 18 to 49 using such Internet sites as Facebook, Twitter, Instagram and YouTube to keep in touch with friends and family, the chances of a claimant using social media is high enough to warrant a thorough look when trying to ascertain whether the claim is legitimate, according to Mr. Cassell.

“Just think about how many of your claimants fit” in the ages and demographics, said Mr. Cassell, who provided statistics from the Washington-based Pew Research Center of who's on social media.

“There's so much available at our fingertips,” added Andy Olwert, Sarasota, Florida-based president of SUNZ Insurance Co., who presented alongside Mr. Cassell.

Mr. Olwert said he wants to see more insurers and other organizations investigate claims using information that is publicly available, because the savings can be profound.

Take the case of the football player presented at Tuesday's session. In side-by-side videos, Mr. Cassell showed a legal video deposition of a man placed on no-work status after being diagnosed with “neck sprain, right shoulder pain and back sprain,” according to Mr. Cassell's slides. The man, questioned by an attorney not pictured in the video was asked to rate his pain on a scale of 1 to 10. “It gets up to a 10,” the man said, in a low and confident tone, pointing to his shoulder and neck.

Beside the window featuring the man's deposition was silent video, recorded by an investigator, of the man playing football just days after his alleged injury. The side-by-side presentation of what the man said and what he did on his free time and posted on social media ignited chuckles from the audience.

Mr. Cassell, whose company worked on the case, said the insurance adjuster spotted some red flags in his initial deposition and called for a social media investigation, which revealed that had been playing with an adult football league. The investigator found the team's practice and game schedule and subsequently recorded the man tackling, running, catching and more. According to Mr. Cassell the insurer facing the man's claim spent $235 on a social media investigation and $4,000 on real-time surveillance. The company saved an estimated $87,000 and averted a potential permanent total disability claim, he said. The man is now facing criminal charges.

Mr. Cassell urged attendees to enlist the help of a vendor with the experience to use a social media approach.

Mr. Olwert said the challenge lies in the nature of the insurance industry itself, and that the solution is to involve every department in the end result — the savings.