Fraud, waste and abuse (FWA) continue to be a significant driver in workers’ compensation program costs. The result for many programs are higher costs per claim, which are passed along to the insured. This trickle-down effect ultimately hurts the employees, which are the people served by workers’ compensation insurance programs. Now is the time for interested stakeholders to employ innovative and creative investigative techniques used advanced techniques in claims investigation based on easy to use technology.
Social Media: Going Beyond the Basics
Social media investigation continues to be an area of initial research in every workers’ compensation claims investigation. This is based on the continued growth in it is use over the last decade. It is also an important area to investigate given its use with all generations. The use of Facebook is a common example:
- There are currently over 1.5 billion users of Facebook worldwide. The United States contains some of the most active users on this social media platform;
- Over 72% of people who use the Internet are connected on Facebook; and
- Nearly 10% of Facebook users do not change the privacy settings on their account. This means there is still a significant portion of users who allow all posts and updates to be visible to the general public.
Pictures posted to Facebook and other social media often contain hidden metadata. This is information stored in the background due to the user failing to adjust the settings on their smartphone or other cameras. The result is a treasure trove of information for the taking. This includes:
- Date and time stamp information as to when the photograph was taken; and
- Specific longitude/latitude information as to where the photograph was taken.
Using this data, someone creates a “geofence,” which tells the world when and where a specific event took place. It also limits the ability of someone to testify otherwise.
Vehicle Tracking and Sightings
State and local governments have employed millions of public security cameras across the country to capture real time images of what is taking place in their communities. Part of this technology includes the use of license plate tracking information, which records when and where a particular vehicle passes a certain location.
While accessing and searching this information may be time-consuming, it can establish a number of items that can be useful in a claims investigation.
- The location where a claimant’s vehicle has visited;
- Establish a pattern of locations visited by an employee;
- Verify the testimony of an employee concerning the route taken to a certain location, which is important in “traveling employee” cases; and
- Accessibility of information nationwide—it is used in every major city in the United States.
Keyword Search Technology
Most social media platforms are driven by “keyword” search technology. This allows all users to use various terms and locate posts and other information from all users on the platform.
In the context of a workers’ compensation claims investigation, any user can ethically search to find information on where someone has been. This includes postings by organizations or events listed in the platform that tag or record the names of attendees. Although a user has set their privacy to limit the information from strangers, the fact someone else has a posting that includes a specific person’s name allows the public to obtain information.
Members of the claims management team have lots of readily accessible information at their hands based on today’s technology. Proactive members will learn how to harness this information to advance and coordinate surveillance on workers’ compensation claims in a cost-effective manner. The ultimate result is lower program costs and quicker claims resolution on troublesome files.
Author Michael Stack, CEO Amaxx LLC. He is an expert in workers compensation cost containment systems and helps employers reduce their work comp costs by 20% to 50%. He works as a consultant to large and mid-market clients, is co-author of Your Ultimate Guide To Mastering Workers Comp Costs, a comprehensive step-by-step manual of cost containment strategies based on hands-on field experience, and is founder & lead trainer of Amaxx Workers’ Comp Training Center. .
Workers’ Comp Roundup Blog: https://blog.reduceyourworkerscomp.com/
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.