Multiple Fake Claims
Founded on the principles of professionalism, integrity, and service which are paramount to the success of any investigation.
Worldwide Resources, Inc
Staged Accidents & Fake Claims
Staged accidents are often meticulously orchestrated by criminal organizations. Prior to these incidents, they methodically prepare their strategy to capitalize on the supposed "accident," often involving counterfeit medical treatments. Additionally, they may exploit the situation through fraudulent auto-body repairs or by securing substantial third-party judgments.
We've witnessed the deliberate establishment of medical clinics tailored for exploitation by these criminal networks, serving as fronts for providing dubious medical "treatment." Moreover, we've encountered instances where "runners," previously tracking accident victims via police radio, resort to orchestrating their own accidents, further complicating the web of deception.
How it happens
Staged accidents manifest in various forms.
For instance, in New Orleans, particularly in cases involving third-party auto insurance, perpetrators deliberately collide their vehicles with eighteen-wheel semi trucks. Their proficiency is such that they execute these maneuvers without inflicting significant harm to themselves, yet manage to file substantial third-party claims against insurance carriers.
On the other hand, in Florida, where no-fault auto insurance prevails, staged accidents often involve two cars intentionally colliding. The modus operandi is to stage the crash near a stop sign within a residential area, ensuring minimal witnesses. Following the collision, the parties involved contact their insurance provider, provide falsified reports to the police, and then proceed to a fraudulent medical clinic. This type of fraud precisely aligns with the scenario depicted in the stock photo above. Here, claimants purposefully await police involvement, believing that a police report might facilitate their claim's acceptance through the insurance carrier's screening process.
How we spot it
We've developed proprietary algorithms designed to analyze your data continuously. These algorithms are finely tuned to identify patterns within accidents, particularly concerning the involvement of specific treating clinics or auto-body providers. They excel in detecting clusters of accidents that are highly improbable to occur by chance alone. Once identified, these flagged claims are swiftly escalated and presented as leads to our Special Investigations Unit (SIU) department, ensuring timely and effective action.
Why are we different?
Our primary objective is to furnish leads to the SIU, not to develop a system aimed at expediting claims. We've observed numerous algorithmic solutions marketed with the intent of streamlining claims processing. While expediting claims remains at your discretion, our commitment lies in thoroughly analyzing all claims in your system and promptly flagging potential instances of fraud for the SIU's attention. Moreover, our algorithms possess the sophistication to detect fraudulent behavior even among individuals who may have eluded databases pertaining to prior criminal activities, such as recent immigrant arrivals.