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DavidMorse.com Fraud Chronicles 12: Hey Mister, Put Down That Tire Iron




By Tom Reitze

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.

When a case contains indicators of possible fraud, an investigator is often brought in to find out the true facts. David Morse & Associates (http://www.davidmorse.com) investigates and conducts surveillance, and if an insurance claim is found to be fraudulent, turns the information over to the insurance company.

This is a case from the David Morse & Associates archives, Part 12 of the Fraud Chronicles, involving a case where our investigator had to go into a risky situation to get the video that broke the case.

Hey Mister, Put Down That Tire Iron
By Mark Quann, Investigator, Los Angeles

"Normally investigations don't involve an excess of adrenaline in the blood system. Or if they do, one has screwed up big time. But every now and then the only way to get a product requires that an investigator walk where angels fear to tread.

"The subject was a mechanic who had filed both a Workers Compensation claim and a civil suit, after catching a car tire thrown from the back of a truck with his head. He claimed he couldn't move his arms above his shoulders. The fact that the subject's wife was also out on disability caused the insurance company to suspect that something might be amiss, so they assigned the case to us.

"The first suspicious point that turned up was that the subject was back at work in another shop as a mechanic. I traced him to where he was working - a huge complex of garages servicing virtually every kind of vehicle.

"Wearing a work shirt, motorcycles boots and carrying a toolbox, I had no trouble getting into the compound and locating the subject. He was working on motorcycles up on a rack. The good news for us was that this is an activity that requires extensive use of the arms in a position above the shoulders. The bad news was that his work station was directly in the center of a huge garage, about 100 feet from the bay doors at either end. No way to get film from outside the garage.

"While walking around to locate the subject, I realized that I fit in perfectly and no one gave any thought to my presence amongst the hundreds of mechanics in the compound. All I needed was a way to get close and film. Inspiration struck. My toolbox would hold the video camera easily. All it required was a few modifications - a hole drilled for the lens, a sheet of dark plastic to cover the hole and a specialized device to adjust the height of the camera (in this case - a towel scrunched under the camera).

"I arrived the next day, only to find I had missed him (morning shift only). But in looking around, I found vending machines about 20 feet from his work station, and right next to these - a table of the perfect height for filming.

"The next day I got there early. There was our subject, his arms stretched above his head. My toolbox and I made our way over to the vending machines and I set my secret weapon on the table. I got coffee. I opened my toolbox, turned on the camera, got it aimed directly at his work station, and adjusted the focus.

"As I was doing this, our subject (a big muscular guy) walked a few feet away to the machine used to separate tires from rims, an activity that would rip the arms out of the sockets of a normal person. I couldn't resist and shifted my toolbox so it recorded the exertions of our subject while I inspected the pastry and candy offerings.

"Our subject returned to his station. I got a tool out of the box while adjusting it back to cover him. I had it. Camera height was perfect, focus was perfect, light was perfect, and fortunately my heart was able to stand the pounding. I had been hanging around the vending machines for close to 20 minutes getting film in plain sight of the subject.

"I left the tool box with camera running and got out of there, returning to my vehicle in the parking lot and taking a well-earned rest while the camera did the work. My pulse returned to normal. But not for long - an hour passed and I had to return to retrieve the tools of my trade, providing they were still there and were not discovered.

"I entered the bay, my eyes peeled for big, burly mechanics with tire irons waiting in ambush. No problems. I retrieved my toolbox, glancing at our subject at work on yet another motorcycle with his arms above his head

"The film was gorgeous. The attorney was ecstatic. Our subject's claim was denied, his lawsuit soon to be dismissed and used in evidence against him for fraud. And I was in one piece, a most desirable situation."

Another victory for truth, justice and lower insurance premiums.
 
 
About the Author
Tom Reitze is President of David Morse & Associates (http://www.davidmorse.com/about.shtml), an independent investigations and claims adjusting company with 45 offices in 15 states. To see other Fraud Chronicles articles, go to http://www.fraudchronicles.com/stories.shtml.

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  Some other articles by Tom Reitze
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 point, the proper action is not to throw water on ...

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 ...

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 all insurance premiums ...

DMA Claims Services Fraud Chronicles 9: Busted on Fairway Five
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 ...

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 not really ...

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 presented, any written statement that is materially false and misleading to obtain some ...

  
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