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Mild Michigan Weather Makes Winter Claims Surveillance Payoff

Posts Tagged ‘ claims ’

Mild Michigan Weather Makes Winter Claims Surveillance Payoff

Thursday, January 12th, 2017

The mild Michigan weather makes winter claims surveillance payoff for many clients. As we work into mid-January, we have had an strong demand for Michigan claims surveillance at a time that would normally be much colder and potentially less productive. Although we have had several truly cold days and several days of ice or snow that cancelled school and tangled traffic, in comparison to prior years, this has overall been a very active time for claimants.

winter claims surveillance

Great weather to skate and be filmed!

So far this year our surveillance team has had numerous days activity with people outside living life almost like they would in the fall. The lack of heavy snow and ice has also created some great opportunities to get footage of people shopping, exercising, eating lunch outside and taking down holiday decorations. When we did get snow thus far, the majority of the clearing activities were done in the daytime and many of the claimants were not bundled up to the point of being unrecognizable making for some truly telling video.

If you have a Michigan claim that could benefit from claims surveillance, don’t wait, call us today and take advantage of this opportunity.

When a government agency decides to get in the way of your investigation

Wednesday, September 2nd, 2015

When a government agency decides to get in the way of your investigation. Much attention has been focused on the Rowan County, KY clerk who is refusing to issue marriage licenses to gay couples. This brings to mind an unfortunately regular occurrence that we, as licensed private investigators working on complex claims investigations and background checks, encounter with government agencies refusing to provide information or records that they are legally obligated to.

In some instances, the agency we are trying to work with is gigantic and the bureaucracy gets in the way. For instance, being located in metro-Detroit, we have had constant battles with the City of Detroit to try and get Freedom of Information Act requests answered. In instances like this, there is no one person getting in the way, and the carousel of “leaders” that we contact  appear not to care or lack the ability to respond. (Note: working with the City of Detroit is getting easier and they are much more efficient these days, the City of Chicago, not so much) This spring, our office received a response to a FOIA from Detroit 21 months after it was submitted! We also encounter the opposite where a smaller municipality elects not to cooperate for political reasons. In a case in 2014, we attempted to get records from a smaller city in Montana regarding a fire department call to a claimant’s residence. The city attorney turned out to be close friends with the plaintiff’s attorney and stoned walled us. In a separate instance, a City Attorney of another town said that if we did not disclose the nature of our investigation and who we were working for, which we cannot by law, he would never release this information and he would certainly find out through discovery if we sued for it.

For those of your who are familiar with FOIA law, you might ask, why not sue them? Well in most cases, our clients simply do not want us to take it that far. In others, the time, energy and cost to do so far outweighs the benefit the records may impart to the case. The really bad news is that these agencies and bureaucrats know this and the reality is that most of the time it works and the requester goes away. The salt in our wound is that sometimes our client does not appreciate this possibility and see the failure as bad investigators who don’t know what they are doing.

Colder Weather Not A Factor in Michigan Casualty Claims Surveillance So Far This Year

Saturday, January 17th, 2015

Michigan in January can be bad. Last year alone, the cold, ice and snow was so sever that everyone suffered, the economy came off the rails and life here was anything but usual for several weeks. The good news is, thus far 2015 has little to resemble 2014. With only a few days reaching below the fifteen degree mark, life has been normal and operating as usual. Please are still shopping, going to school, attending IMEs,  recreating outdoors and very visible in public domain. In short, the casualty claims surveillance business in Michigan is red hot right now!

Here at Sherlock, we have made good use of this weather and achieved some excellent surveillance results. For some, there is the idea that January is just too cold and snowy to produce good insurance claims surveillance, but this year, that crowd is missing some great opportunities and allowing for some bad claims to move further along than they should.

If you have questions or concerns about the viability of claims surveillance at this time of year, we encourage you to call us. We can give you a detailed understanding of the opportunities and a variety of ways for you to potentially take advantage of the weather, as opposed to being a victim of it.

Sherlock Investigations: Michigan Casualty Claims Surveillance Experts

6 Common Auto Insurance Fraud Schemes Other Than Fake Casualty Claims

Wednesday, December 17th, 2014

As everyone involved in the fight against auto insurance fraud in Michigan knows, Michigan first party or PIP fraud is one of the most prevalent and costly. Beyond the false casualty claims we find a number of other types of auto insurance fraud schemes that are also rampant and very harmful.

Auto Premium Evasion: No one wants to pay more for auto insurance than they have to, but premium evasion is the deliberate falsification of one’s address for the purpose of getting a lower rate. This is a common practice and results in significant loses for insurance carriers. If you are caught evading your premium, your policy will likely be canceled and your money lost.

Towing Scams: These are when tow trucks cruse for broken down vehicles ad render help. Unfortunately they also often over charge and many times will submit claims against your insurance carrier for other services that they did not render.

Windshield Replacement Scams: This is when a windshield repairman shows up in a parking lot and offers to fix you windshield for next to nothing. You will get a new windshield, but most of the time the installation and windshield are poor and in the end they really just want to file multiple claims against your auto insurance carrier.

Insurance Agent Fraud: This is when the agent you buy the policy from keeps your money and pretends that you have coverage. The results can be catastrophic when this happens and someone has a loss but no coverage. This happens far more often than people realize.

Counterfeit Airbags: Like it sounds, this is when a repair shop installs a counterfeit airbag during a repair job. Airbags fetch big money on the open market and the counterfeits may fail to protect you in an accident. Again, this happens way more often than people think.

Staged Accidents: Swoop and Squat, Drive Down, Flag Down and the Enhanced Damage are just a few of these. They are professional accidents and they cost insurance carriers and their insured’s a boat load of money each year. Always document any accident and report suspicious circumstances to your insurance company immediately.


Detroit is Michigan’s Only City in Top 100 for Auto Theft Claims

Thursday, July 24th, 2014

The National Insurance Crime Bureau issues a ranking of the top cities for auto theft called the Hot Spot report. In the 2013 Hot Sort report issued last month, Michigan only had one city in the top 100. Surprise: It’s Detroit coming in at 23. The next closest Michigan city is Flint which came in at 153. One rather shocking element of the report is that 9 of the top 10 cities in this years report are in California. Despite the better than expected placing on the report, Michigan residents and auto insurance carrier face serious loses here in cities like Detroit and Flint. Michigan is also facing serious loses related to fraudulent auto related injury claims which can launch into the six figures in medical costs in a very short time. Sherlock Investigations is a leading private investigative agency here in Michigan and regularly assist in auto theft investigations, interviewing claimant’s and witnesses, verifying service locating, locating and interviewing witnesses and the like. If you work with an auto carrier and need assistance, please contact one of our team. We look forward to helping.

Costly fraud necessitates need for increase Michigan attendant care claims surveillance

Tuesday, June 17th, 2014

Last month the Louisiana Attorney General’s office charged 20 personal care attendants with insurance fraud as part of Medicare fraud scheme. As more law enforcement attention is being focused on attendant care fraud within the scope of Medicare abuse, in PIP states like Michigan, attendant care fraud and abuse is an ever present part of first party no-fault claims. What is truly troublesome about attendant care fraud and abuse in Michigan is how quickly the attendant care bills can get into the six figures, thus costing auto insurance carriers a significant amount of money which is passed on to everyone who purchases auto insurance.

One of the most effective tools that a first party PIP carrier has in fighting this type of fraud is through the effective use of Michigan attendant care claims surveillance. In these cases, the carrier needs to hire a private investigator who is able to watch either the PIP claimant or the attendant care provider. Often times, these care providers and claimants will over state the amount of care being provided in an effort to defraud the insurance company in small amounts, over and over again. Effective, well planned surveillance performed by expert private investigators will clearly demonstrate exactly what the claimant and the care giver are up to. In Michigan, Sherlock Investigations is the intelligent choice for professional Michigan attendant care claims surveillance.

P&C Insurance Fraud Escalates

Friday, April 5th, 2013

Questionable claims numbers and fraud costs expected to grow through 2016.

Justin Stephani of the Insurance Networking News reports:  As the industry attempts to keep up with the growth in insurance fraud and deploy more effective anti-fraud technologies, spending by U.S. P&C carriers on fraud solutions, split roughly evenly between analytics and scoring products and services, is projected to grow by 44 percent between 2011 and 2016, according to a new study on fraud.

Cat Claims Fund Charges Up 21% For Large Michigan PIP Claims

Monday, December 17th, 2012

The premium paid to the Michigan Catastrophic Claims Association (“MCCA”) by
member insurance companies will be $175.00 per insured vehicle effective July 1, 2012 to
June 30, 2013. This represents an increase of $30.00 (21%) over the current MCCA charge of
$145.00. The $175.00 assessment represents $141.93 to cover claims; $32.72 to address the
$2 billion estimated deficit and $.35 for administrative expenses. The current deficit is estimated
at $310.78 per insured car. The MCCA premium charge is determined each year at this time
following its annual actuarial evaluation.
Michigan PIP auto insurance law provides unlimited lifetime coverage for medical
expenses resulting from auto accidents and is the only state in the nation that mandates these
unlimited benefits. (The state with the next highest level of benefits mandates only $50,000).
Created by the state legislature in 1978, the MCCA is a private, non-profit association whose
mission is to protect the financial integrity of Michigan’s auto insurance industry by providing
reinsurance for these unlimited benefits. The MCCA reimburses auto insurance companies for
Personal Injury Protection (PIP) benefits paid in excess of $500,000 per claim.

All auto insurance companies operating in Michigan are required to be members and pay
premiums for the reinsurance provided by the MCCA. These premiums, together with the
insurer’s PIP premium, represent the cost to cover the mandatory unlimited medical benefits
which, like other costs and expenses, are reflected in the auto premiums all Michigan
policyholders pay.
Each year more individuals receive benefits resulting from catastrophic automobile accidents
and their claim costs are rising. Estimating the ultimate costs of these benefits requires
sophisticated analysis but the trend of increasing costs is a key driver of changes to the MCCA

The MCCA paid out $927 million (more than $133 per insured car) in 2011 for claim costs
resulting from catastrophic injuries. The majority of these catastrophic injuries involve closedhead injuries, paraplegia, quadriplegia and burns. Since 1979, there have been over 28,000
claims reported to the MCCA, which will cost an estimated $85 billion.

Additional information on the MCCA, including claim payment statistics, audit reports and
answers to frequently asked questions can be obtained from its public website: