INSURANCE FRAUD INVESTIGATIONS

Insurance fraud is a common, widespread problem, but it’s often viewed by its perpetrators as a victimless crime. Fraudulent insurance claims cost the Canadian insurance industry an estimated $3 billion annually in insurance premiums and health care, and most of those costs are absorbed by honest consumers. The private investigators at Platinum Investigation are equipped to investigate a range of suspicious insurance claims related to workers’ compensation, accidents, health care and medical insurance. We effectively use investigative methods such as surveillance, interviews and record searches to get you the answers you need regarding suspicious insurance claims.

WSIB Fraud Investigation

Each Workplace and Insurance Board (WSIB) claim costs employers tens of thousands of dollars. Fraudulent workers’ compensation claims increase rates and premiums for employers, who must also absorb the time lost to lower productivity and the cost of hiring or retraining replacement employees. WSIB fraud can involve false injury claims, exaggerating the effects of an injury or working for another source of income while collecting benefits. Our private investigators can help protect your business from fraudulent WSIB claims. We use a variety of investigative techniques, including surveillance, background checks and photography to get the information you need about suspicious claimants.

Vehicle and Accident Insurance Fraud Investigation

At least 26% of personal injury insurance claims contain elements of fraud, according to a study conducted by Insurance Canada. Automobile insurance crime is increasingly prevalent in Canada and ranges from opportunistic fraud when the claimant knowingly inflates a claim, to premeditated fraud such as staged automobile accidents or a faked “trip and fall” incident in a store. Dishonest professionals and businesses can also be involved in the deceit; from tow truck drivers to automobile repair shops and even health care providers, accidents provide many opportunities for fraudulent insurance claims. Our background in law enforcement means that Platinum Investigation PIs are experts at investigating the legitimacy of the accident and personal injury claims, and documenting the factual evidence necessary to identify fraud.

Health and Medical Insurance Fraud

Public and private health care and medical insurance fraud costs Canadians an estimated $12 billion. Obvious forms of fraud include using another’s health card, feigning an injury or illness to collect insurance benefits or obtaining drug prescriptions from multiple doctors. Health care providers can also commit fraud by misrepresenting services or performing unnecessary treatment. With private health care insurance, one fraudulent claim can affect an entire group’s premium and level of coverage. Platinum Investigation PIs are experienced in investigating suspicious health care or medical insurance claims and uncovering the truth. (Perhaps some specifics in terms of techniques would be useful here)

Contact us today for your free consultation.