Insurance Fraud Investigations Can Benefit Greatly From Social Media Access

insurance fraud

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Insurance fraud is an issue that costs the industry $40 billion each year in non-health insurance claims alone, thus affecting customer premiums by around $400 to $700 per family, according to the most recent data from the Federal Bureau of Investigation (FBI).

Anything insurers can do to crack down on the amount of fraud ultimately benefits honest, hard-working customers. As a result, investigators prefer to leave no stone unturned when it comes to dealing with suspicious claims. And in the last few years one of the most helpful tools in the fight has been social media access.

A number of recent court decisions have paved the way, according to The Fraud Report. Here’s what you need to know about insurance fraud investigations and use of social media:


Social Media Is Discoverable

TFR notes one case — Beye v. Horizon Blue Cross Blue Shield of N.J. — in which an insurer was granted access to all communications involving allegations from the complaint. In another, a company was granted access to Facebook and Myspace passwords to search for additional areas “to determine whether or not plaintiff has made any other comments which impeach and contradict his disability and damages claims.”

“These cases prove that social networking information that is revealing, or relates to, or that simply refers to allegations raised in a complaint are, most likely, discoverable,” TFR notes.


Privacy Settings May Not Matter

Not only is social media evidence discoverable, according to recent findings, investigators may also be able to circumvent privacy settings in special circumstances.

In much the same way a defense attorney can request medical, employment, or other records, they can access social networking records that are relevant and not publicly accessible through discovery, write Professor Gregory Duhl of the William Mitchell College of Law, and attorney Jaclyn Millner in a recent article.

They believe a privacy argument is unlikely to stand in court because “a person has no reasonable expectation of privacy in whether he or she has a social networking account or in what is posted in his or her profile,” adding that since information is available to at least some third parties under enabled privacy settings, data remains fair game.

One example: the case of Romano v. Steelcase Inc., in which it was shown that anything posted on Facebook or any other social networking site — whether the privacy settings are in use or not — is “likely discoverable.”

Refusing to comply or deleting data does no good either as the social network itself can be subpoenaed and forced to provide the deleted material.


Social Networking Accounts Are Turning The Tables Against Fraud

Duhl and Millner agree that social media is opening possibilities for investigators to stamp out the sheer enormity of insurance fraud, pointing out that most of the time, “Facebook evidence will corroborate other evidence that was found, such as a statement from a co-worker or witness, and surveillance, such as video,” as well as medical records that call in to question the plaintiff’s injuries and pictures that a property in question wasn’t damaged.

Of course, with this tool, insurers are under obligation to access and use the information presented responsibly per the terms of the Stored Communications Act. That being said, it’s a formidable weapon in the fight against fraud and one that can benefit the industry, and insurance customers, for many years to come.

Do you think social media — regardless of privacy settings — should be “on the table” during an insurance fraud investigation?

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