Filed Under:Claims, Claims Technology

Social Networking and the Claims Investigation

Back when many of us began our careers investigating claims, we did it the old fashioned way. There was no Internet, cell phones were the size of suitcases, and email had yet to replace inter-office memos. Somehow, we managed to get by using the relatively scarce resources available at the time.

The key to success was a combination of intuition, tact, and perseverance, where significant time was spent knocking on doors, canvassing witnesses, and searching for the truth. If it was suspected that a claim was a fraud, there was no such thing as link analysis technology to validate the hypothesis. Rather, clues had to be gathered and put together like a jigsaw puzzle.

Prior injuries and unrelated vehicles weren’t readily identifiable, but nosy neighbors and bitter exes made the job a little bit easier. Skip tracing was a manual process, and the local sheriff proved to be an invaluable ally when trying to enforce judgments.

Fast forward 20 years and these things seem so routine. With the click of a mouse, we can locate people, assets, jobs, personal property, and an array of other things that make investigating claims a little easier. Is this technological advancement, however, a detriment to fundamental blocking and tackling?

Technology, along with people and processes, serve as a basic foundational element to any organization. However, technology can also be used as a crutch to explain away organizational gaps, breakdowns, or failures.

People are the most crucial element in any successful endeavor. As a result, they must have the training and skills necessary to properly execute basic fundamentals. Technology should be considered nothing more than a tool to make them better at what they do.

Technology, in particular social networking, can also be a distraction to those not properly trained and monitored on utilization. Certainly seeing the injured party with “significant limitations related to the accident” on YouTube in some type of contradictive behavior can add significantly to an investigation. That said, employees chatting on Facebook about plans for the weekend doesn’t serve to improve organizational quality.

The key to successful utilization of technology begins with management, where expectations guide organizational calibration.

According to a study by Salary.com, employees spend an average of two hours per day on the Internet. This can be good, bad or somewhere in between, depending on what they are actually doing. Monitoring Internet usage with a variety of tools available can provide valuable insight, as well as limiting company losses that occur with uncontrolled access. Aside from the potential for wasted time, unrestricted Internet access can open the network to viruses, spyware, and other security problems.

From a claims professional’s vantage point, there are a number of online applications that can assist with many aspects of the claims process. Social networking can give insight into the behavior of claimants. Automotive and property sites can be used to assist with the valuation process. Internet-based investigative resources can help root out fraud. Weather resources can identify historical climate data and the list goes on.

Perhaps more than anything, claims leaders should recognize that the online experience will serve to make their best employees much more efficient, while bogging down their worst employees with distractions.

The great employee will use the Internet to dig deeper, seeking out answers to questions not yet even asked by the marginal employee. Consider the following example:

Two cars collide at an intersection. The insured readily admits fault, saying he didn’t see the stop sign. The occupants of the claimant vehicle retain the services of an attorney and get medical treatment from a local chiropractor. The marginal adjuster may confirm the accident facts with both parties, pay estimates on both cars and move along to the next claim. The great adjuster will recognize that there may be more than meets the eye.

Great adjusters will leverage the Internet to dig deep. They will not only ask questions of the parties to the claim, but also they will look for discrepancies. They will inquire about not only their medical treatment, but get physical descriptions of their clinics and providers. The good adjuster will ask for directions from home to the chiropractor’s office. They will measure the damages and look for metal striations and paint transfers. The list of what the great adjuster will do goes on and on and at the end of the day may show that this ordinary claim was actually a staged accident.

While the Internet cannot replace basic blocking and tackling, and introspection and intuition, it can be a great resource. Below are some free sites available on the Internet that can provide a wealth of information:

Skip Tracing Websites and Resources

www.spokeo.com      

www.411.com                       

www.pipl.com                       

www.anywho.com                 

Social Networking Sites

www.facebook.com

www.myspace.com    

www.linkedincom     

www.plaxo.com         

Weather History

www.wunderground.com/history/

License Suspension Guidelines

www.christidball.com

Real Property, Asset and Liens

www.google.com/earth/         

www.salary.com        

www.zillow.com

Subrogation Resources

www.ambest.com      

www.arbfile.org         

www.subrogation.org

Government Resources

www.cms.gov            

www.dol.gov             

www.noaa.gov           

www.nhtsa.gov

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