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 typically preplanned by criminal organizations. In advance of the staged accidents,
they have set up their method to benefit from the “accident”; which typically is through fake medical treatment
but also can be through fake auto-body work or large third party judgments.
We have seen medical clinics be formed explicitly to be used by these criminal organizations to provide medical
“treatment.” We have also seen where “runners”, who already were chasing down accident victims via police radio,
resort to fabricating their own accidents.
How it happens
There are multiple ways a staged accident can occur.
For example, in New Orleans, where third-party auto insurance is involved, the perpetuators would purposely
slam their vehicle into eighteen wheel semi trucks. They were so expert at it, they could do it without
really hurting themselves, but making massive third-party claims against insurance carriers.
On the other hand, in Florida, where no-fault auto insurance is involved, typically two cars purposely
“crash” into each other. The M.O. is to crash near a stop sign in a residential area where there are no other
witnesses; call the policy; give a fake report to the police, and then go to the fake medical clinic. This is
the type of fraud we contemplated when we selected the stock photo above. In this scenario, the claimants have
purposely waited for the police because they believe a police report may make their claim get through an
insurance carrier’s screening process.
How we spot it
We have proprietary algorithms that are constantly sifting through your data. We have calibrated these
algorithms to detect patterns in accidents, especially in regards to their treating clinics and/or
auto-body providers, which detect when a series of accidents occur which very likely were not caused
by chance. As soon as this becomes apparent, these claims are flagged and immediately given as leads
to an SIU department.
Why are we different?
Our focus is to provide leads to SIU, not build a system that “pre-clears” claims. We have seen many algorithmic systems sold with the purpose of fast tracking claims. Whether you fast track a claim is your business; but we will analyze all claims as they go through your system and provide a lead to SIU when potential fraud is spotted. Furthermore, our algorithms are not fooled by people who have managed to stay out of databases related to past criminal activity, such as recent immigrant arrivals.