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  Category: Articles » Society & News » Law » Article
 

DMA Claims Services Fraud Chronicles 9: Busted on Fairway Five




By Tom Reitze

There's something about the idea of someone living the high life, while out on a fraudulent disability claim, that rankles those of us who have to work for living.

In suspicious disability cases, an investigator is often brought in to find out the true facts. DMA Claims Services (http://www.dmaclaims.com) investigates suspicious cases, conducts surveillance, and if a person is found to be engaged in activity inconsistent with a disability claim, films the subject in the act. Then that evidence is turned over to the insurance company.

This is a case from the DMA Claims Services Investigations archives, Part 9 of the Fraud Chronicles, where the subject was living high off his disability checks. But not for long…

Busted on Fairway Five

"Our subject was out on a total disability claim, from a back injury. That disability claim was paying our subject enough money to maintain a rather high-level lifestyle, which included a late-model luxury car, country club membership, and a gated house in the hills. There was only one problem with this happy scenario – our subject was a fraud, lying through his teeth.

"His golf swing was not going to give Tiger Woods a scare at Augusta anytime soon. But it was a beautiful morning on his country club's course and you could see our subject was having a very good time. No pain, no hesitation, no problems swinging or picking up the ball.

"The only reason someone might photograph this fellow's swing was due to a certain professional disability claim. You see, most people who are actually totally disabled, are not usually found on a beautiful Saturday morning getting in 18 holes at the golf course. It was my job to film this happy game of golf and bring our fraudster's country club days to an end.

"The problems of getting film on a country club course are not insubstantial. You can't walk around, hang out at the tees or greens, and they kick you out if you try (which I did, and they did). Thank goodness they like to build houses near golf courses, and houses require streets, streets which provide views onto fairways and tees. Before the polite ejection, I was able to get a bit of the layout of the course and acquire a score card with a map. I was then able to map out my scenic overlooks.

"Once the preparations were complete it was a matter of following the claimant to his country club, estimating his tee time and waiting in spot number one. There he was. No trouble bending as he teed up the ball. No trouble with the practice swings. OK, there was our first sign of trouble – a nasty shank off to the right. He was never going to find that ball. He took a "mulligan", bent, teed, took a practice swing and, lo and behold, a much better shot, short rough on the left, almost 200 yards out. He was happy, and, thanks to telephoto technology, so was I.

"The morning passed into early afternoon and at no point did our tireless golfer show any sign of strain, fatigue, restriction of movement, bravely hidden back pain, or crippling disability. His game appeared to improve a bit as the day wore on (though still nothing to write Golf Digest about).

"The report and film arrived with our subject's benefactor, and it appeared that certain changes in lifestyle were about to occur. Naturally like any benefactor scorned and cheated, our client was taking action. No more free country club lunch for our subject."

Another victory for truth, justice and lower insurance premiums.
 
 
About the Author
Tom Reitze is President of DMA Claims Services (http://www.dmaclaims.com) , an independent investigations and claims adjusting company with 45 offices in 15 states.

Article Source: http://www.simplysearch4it.com/article/48744.html
 
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  Some other articles by Tom Reitze
DavidMorse.com Fraud Chronicles 12: Hey Mister, Put Down That Tire Iron
Insurance fraud hurts everyone. When someone lies about being disabled, or worse yet, collects disability benefits while going out and getting another job and working, that inflates the cost of insurance for everyone. ...

FraudChronicles.com 3: The Wicked Witch of Insurance Fraud
Appearances can be deceiving. Some older lady may remind you of your grandmother, that is, until she starts filing fraudulent insurance claims. At that ...

DMAClaims.com Fraud Chronicles 10: Diagnosis – Fraud
Occasionally a person gets traumatized in the workplace, and a psychiatrist can't figure out what's wrong with them. But sometimes, it's so simple that it eludes the "professional" with the supposedly advanced degrees, but is plain ...

FraudChronicles.com 2: You Insulted My Equipment!
When a person commits insurance fraud, by claiming to be injured or disabled from a work-related incident when they are not, honest people suffer through higher insurance premiums. It is estimated that 25% of ...

DMA Claims Services Fraud Chronicles 8: Greasy Spoon Film Busts Fraudster
The whole point of Workers Compensation insurance is to pay benefits to people who have been injured on the job, and cannot work. But what if someone is ...

David Morse & Associates Fraud Chronicles 7: Perils of Car Maintenance
Insurance fraud is a crime, defined as "when someone knowingly and with intent to defraud, presents or causes to be ...

  
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