August 2017
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On behalf of all of us at Trace Investigations, we wish you a joyous Labor Day weekend, and that your thoughts and prayers are always for those who are less fortunate in light of the recent catastrophic climate events, and for our men and women who serve our great nation in uniform, wherever they may be.
"Fraud and falsehood only dread examination. Truth invites it."
 
- Samuel Johnson

We are grateful to have the opportunity to provide you this valuable information. We take special care to ensure the information we provide you in "Tracings" is the latest and most current information available . In this edition, we offer a case study that exposed a fraudulent Workers Comp claim; and we emphasize the need for a proactive approach in investigating all forms of occupational fraud.
 
The goal of this e-newsletter is to provide you with critical information that will help you prevail in your business affairs wherever fact finding is an essential component. We will share what we have learned in our 30+ years as professional investigators and intelligence analysts.

We want to write about topics that will assist you in succeeding in your business endeavors. Please e-mail us your topics of interest to
tracings@traceinvestigations.com.
 
We encourage you to share our e-newsletter with others in your sphere of influence. 
 
Sincerely,
The Trace Team

art1CASE STUDY - Investigating Workers' Compensation Fraud: "Everything, including the kitchen sink."
Let's call him Charlie.
 
Charlie was on Worker's Comp injured leave from his job at a large industrial construction company. He had allegedly injured his back to a degree where he would no longer be able to lift anything, including the lumber and steel framing sections, which was part of his primary duties with his employer. The employer was self-insured and their in-house claims manager suspected that Charlie had exaggerated his injuries. Charlie's medical examinations had documented only soft tissue injuries in his lower back and he had been on WC leave for over four weeks, in the height of the construction season. The claims manager (let's call him Ned) believed that Charlie should be able to return to work. Ned contacted Trace Investigations, and asked that we place Charlie under surveillance for a few days to document his activities. Almost any activity outside of walking and riding in a vehicle would be enough to question his injuries.
 
Our investigator was able to establish a safe and secure position in Charlie's neighborhood to watch the home and its front yard and driveway. A second investigator was parked a block away with a good view of Charlie's back yard. If Charlie did anything, they would be able to video any activity and follow him if he left in his vehicle, a late model pickup truck. The first two days not much happened. Then, early the morning of the third day as the sun was coming up, the investigators headed to Charlie's neighborhood for what they feared would be a third day of no activity.
 
That quickly changed. As the lead investigator ... Read More

art2   Insurance Fraud: A cost we all pay.
Fraudulent insurance claims cost the industry $5 billion annually. Unfortunately, the cost of fraud is not limited to any one entity; policy holders, employers, consumers, insurers and shareholders all bear the expense. The money paid out towards false claims could fund 38,133 four-year college educations.
When anti-fraud preventions fall short and people take advantage of the system by filing false disability claims, there is one sure way to address indicators of fraud in a claims: Hire a team of professional investigators.
 
Early investigation of a suspicious Workers Comp claim leads to early evidence and the chance to avoid costly litigation. Surveillance is a reliable way of obtaining evidence needed in a disability investigation. Interviews and research can corroborate the inconsistencies and build an even stronger case. Following through with the investigation will sequentially decrease the likelihood of other dishonest claimants surfacing.
 
Workers Comp fraud is just one layer of the fraudulent activity by employees. Unrecorded sales, write-off schemes and inventory theft are some of the most common asset misappropriations. As detailed in its Report to the Nation 2016, the Association of Certified Fraud Examiners Inc.'s survey revealed the following: