I had a very interesting discussion with a claims investigator last Thursday at Celent’s industry networking event in London (
As background, this gentleman is the managing director of an independent investigation company based in London that serves the UK market. His company has expertise in both personal and commercial claims, and is hired by insurance companies to detect and research suspected claim fraud.
He confirmed what I have heard from other claims investigators—their first step in an investigation is to check social networking sites for information. What he added was a richly descriptive context in which this information is used.
The interview sounds as if it is out of a television script. Paraphrasing his comments, they went something like this:
“After obtaining some interesting information from social sites, we bring a claimant into the office for a chat. I often say 'May I make you a cup of tea?' I then lay a folder on the desk and say 'Have a look at this whilst I get your drink.' I then leave the room and they invariably open the folder. In it, we have screen prints of Facebook postings, pictures, Twitter feeds, etc., all of which refute basic facts in their claim statement. Many times it is not the pictures that are most incriminating, it is the text that they have posted themselves.
"For example, we have discovered postings that read: 'I had a great time in Ibiza. I danced all night!' (This can cast some suspicion on the status of a back injury that is paying disability!) I return with their tea and say 'Have you had a look? Great. Super. Now, there are only a couple of ways this can go…one, you can sign a paper that relinquishes your claims payments and agrees to pay my fee, or two, don’t sign it and we will hand this information over to the police who will begin a criminal investigation.' Obviously, almost all sign.
I felt as though I was in a television show, but a couple of specifics really intrigued me about his comments. First, when I have seen the “have a look at the folder” technique on TV, it almost always contains pictures that someone has taken without their knowledge, or transcripts of wiretaps—both collected by a third party. What is very different about this “evidence” is that the claimant posted it him/herself and offered it freely for the world to see. Something to be said for the efficiency of self incrimination.
Second, I agree that there is an uncomfortable, “big brother,” “Orwellian” aspect to this type of monitoring. I have seen some opinions that criticize insurance companies for using such tactics. My stand on this issue is that insurance fraud costs all of us money and if someone who is adding to my insurance costs can be found out through their own hand, I am all for it. Invading privacy is not acceptable, but using what is voluntarily placed in the public domain should be employed to its full use in order to match insurance rates and coverages with actual exposure.
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Mike Fitzgerald is a senior analyst in Celent's insurance practice, and can be reached at mfitzgerald@celent.com.
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