Social media websites are often a great source of informationfor fraud investigators. These sites are a place where people postevery little detail of their day-to-day lives. This information ishandy for investigators, especially when claimants post thingsabout their frequent activity while they are supposedly disabledand collecting workers' compensation.

The most recent issue of the Journal of Insurance Fraud inAmerica (JIFA), published this summer, details how legalprofessionals, investigators, and other insurance companyrepresentatives sometimes deceive suspects into giving upinformation from these sites. Jim Quiggle, director ofcommunications at the Coalition Against Insurance Fraud (CAIF),explained that social media is the up-and-coming source ofpotential evidence in any kind of fraud investigation.

“Everybody is mining social media for clues in fraudinvestigations,” Quiggle said. “People love to brag about theirexploits on those sites. A person can tell all their friends how heor she scammed an insurer—people cannot resist the impulse.”

Right now, states have varying laws as to how lawyers, agents,investigators, and other insurance company representatives canengage in deception in investigations. Jaclyn Millner, an attorneywith Liberty Mutual and one of the two legal experts who authoredthe piece in the JIFA, explained that states are lookingto other states as these rules are modified.

These templates include rules for obtaining evidence and ethicalrules for lawyers, but one rule that stands out is the rule ofdeceit in investigations—some states have exceptions and allowdeceit if fraud is reasonably expected, but that is theminority.

Although some cases may be more difficult than others, Quigglesaid “if you follow the rules of reasonable discovery, then youshould be able to find most material if you need it.”

Getting Put on the Spot

Millner detailed one case in which a claimant's Facebook accountproved a lack in injury, although the claimant had previously filedfor workers' compensation.

The employee had claimed a back injury and was requestingpayment of medical bills as well as wage loss from work. However,photos on the claimant's Facebook profile showed the claimantclimbing on a ropes course, bowling, lifting weights, and more.

“In almost any case, I think it's worth doing an initial searchof the most common social media sites,” Millner said. “It onlytakes a minute or two, and that person you're looking for may have apublic profile. Once there is something suspected, look at othersites like YouTube where you may find things that contradict aclaimant's allegations.”

Quiggle agreed, explaining that “people love to post theiraction-packed photos even though they have informed their workers'comp insurer of a 75 percent disability and the need for immediatebed rest.”

Once these claimants are put through further questioning,Quiggle said many admit to fraud. “It's not unusual for suspects tocave, because it's just hard to deny the undeniable.”

It is no wonder that these tell-all websites are of great valueto investigators. People love to brag about their accomplishments,and these sites just happen to document and time stamp each andevery one of them.