Getting The Whole Truth And Nothing But?

Interview techniques, psych assessments help investigators spot fraudulent claims

Phoenix

Ever get the feeling someone has been lying to you? A session at the recent 2005 Annual Seminar & Expo on Insurance Fraud of the Baltimore, Md.-based International Association of Special Investigative Units might have been the best place to be to get your suspicions confirmed.

The workshop, titled "The Reid Technique of Interviewing and Interrogation," had one objective--to teach the techniques and tricks of eliciting information from suspects that result in admissible confessions.

The Reid Process, as explained by Joseph P. Buckley, president of John E. Reid & Associates in Chicago, Ill., involves three major steps:

o Behavior Symptom Analysis: In this step, investigators analyze the verbal and non-verbal behavioral characteristics that distinguish a truthful person from one who is withholding or fabricating relevant information.

o The Behavior Analysis Interview: An interview is structured to elicit both factual and behavioral information so as to suggest investigative direction.

o The Reid Nine Steps of Interrogation: The interrogation process is designed to obtain an admission of guilt.

Given that this type of seminar typically is held over the course of three days, Mr. Buckley focused the most important topic for insurance investigators during his afternoon session. "In an insurance investigation, you are looking at whether or not the [suspect] is credible," he said.

Although he cautioned that no behavior is always consistent with telling the truth or lying, there are a lot of common characteristics that can guide your instincts in the right direction, especially when multiple characteristics appear.

His technique in interviewing suspects included two steps. The first involved having a non-accusatory, information-gathering conversation. Generally, this is done in a question-and-answer format.

By using the 80/20 rule--where the investigator speaks 20 percent of the time and the subject 80 percent--the investigator allows the subject to tell their story by utilizing both investigative and behavior-provoking questions.

"Silence is your ally in an interview," said Mr. Buckley. "It gives the subject the chance to keep on talking, and guilty people will usually add information, thinking, 'Did that sound right?'"

Video demonstrations featuring real investigators interviewing their subjects highlighted the session and demonstrated the goals of an interview--to develop investigative and behavioral information.

One case showed Sharon, a single mother and a new employee on the job for one month, being questioned by an investigator using the techniques Mr. Buckley described. Assigned to work a drive-up window at a bank, Sharon stated that she placed $1,500 in a drawer for her supervisor to deposit, but somehow, the money disappeared a short time later.

By watching the investigator implement behavior-provoking questions, attendees saw first hand the lessons Mr. Buckley taught, discussed their own observations, and then offered a verdict based on those observations. Together with the interrogative nature of the investigator and Sharon's verbal and non-verbal responses, a full confession was elicited from her.

"The number one reason a person confesses is that they say the investigator seemed to understand their situation," said Mr. Buckley. "This can be achieved by telling a personal story even worse than theirs to better relate to them and build sympathy."

Determining psychological and neuropsychological injury claims to be fraudulent generally requires a different approach than, say, someone who commits automobile claims fraud or premium fraud.

This is because psychological injuries--such as post traumatic stress disorders--aren't conditions that can be physically noticed. Therefore, a different approach is needed to help distinguish truly injured parties from malingerers, according to David Price, a forensic consultant for The Forensic Network in Greenville, S.C.

"How many people here can actually see depression?" asked Mr. Price, an expert in psychological and neuropsychological claims, during a separate session.

"Can you see depression? Dementia? Post traumatic stress disorder?" he asked.

Only the person making the claim can express what psychological conditions he or she is suffering from. And given the amount of information available on the Internet, it has never been easier for the common claimant to become an expert, he said.

Mr. Price reports that up to 50 percent of brain injury cases have been proven to be fraudulent, noting that signals are typically subjective.

"If you put post traumatic stress disorder into a search engine like Google, you'll get back thousands of hits. You can find sites that tell you what to report and symptoms that allow people to learn about a disorder," he said. "By the time they are evaluated, they have already educated themselves on what they should say."

The exaggeration of a mental illness or disturbance is always a possibility when financial incentives are an issue. Malingering should be considered in cases where you suspect feigning of symptoms or diseases that do not exist in the patient, exaggeration of existing symptoms, or when symptoms have no bearing on the injury being claimed, he said.

Mr. Price recommended using the book, "Diagnostic and Statistical Manual of Mental Disorders" from the American Psychiatric Association, which documents a five-axis approach to assessing a patient and describes how to use this information to tell a story and summarize the patient. The approach includes looking at:

o Clinical disorders of the patient.

o Personality disorders.

o General medical conditions.

o Psychosocial and environmental problems.

o Assigning a "global assessment of functioning" rating.

Once this information is gathered, there are some signs to look for that may indicate fraud is being committed, he said. For example, if a patient is referred by an attorney to a clinician, it should raise a red flag, according to Mr. Price.

A marked discrepancy between a person's claimed stress or disability and the objective findings--such as a patient being released to return to work but failing to do so--should also be noted, he said.

Mr. Price said other combinations of traits that may indicate malingering include a lack of cooperation by the patient during the diagnostic evaluation or in complying with the prescribed treatment regime, and the presence of an anti-social personality.

Eric Gilkey is an assistant editor for NU's sister publication, Claims.

Eliciting the truth. The bright light interrogations of television crime dramas are hardly the way to coax a confession. "Silence is your ally in an interview," according to expert Joseph P. Buckley.

Special Reports /

Getting The Whole Truth And Nothing But?

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