When an adjuster interviews a policyholder or claimant as part of a claim, certain factors can help verify whether or not the information being shared is really the truth.
Any interview should be nonaccusatory with a goal of gathering information about the claim and the events that led up to it.
Sometimes an insured may not be entirely honest. Joseph Buckley, president of the Chicago-based John E. Reid and Associates Inc., shared some of the "tells" that can indicate whether an interviewee is telling the truth during the opening keynote at the International Association of Special Investigation Units 2016 Seminar in Las Vegas this week.
"A deceptive subject will often respond by omission or evasion," said Buckley. He may also answer a question with a truthful answer, just not the correct answer to the question asked.
If a subject doesn't answer the question, Buckley recommends asking follow up questions. "If they didn't answer, they didn't mean to answer," he added. "Deceptive people count on us to fill in the blanks for them and frequently won't say something specific."
The interviewer should use investigative and behavior-provoking questions. How they are answered can be illuminating. For instance, when asking: "What should happen to someone who set the building on fire?" an innocent person will respond that the individual should be punished, arrested or suffer some sort of consequence. A guilty person may look away and say he really doesn't know what should happen.
Buckley also said that just being silent can be an effective way of drawing more information out of a subject. He explained that his investigators use note taking as a reason to be purposefully quiet. "You want silences during the interview. The subject may add to his answer if he is uncomfortable and add something he didn't intend to say. Note taking gives you an excuse to be busy and have a moment of silence."
The interview
How and where the interview is conducted is also important. Buckley recommends against having any furniture such as a table or desk between the interviewer and the subject. "If you have a physical barrier between you and the interviewee, you can only see them from the waist up," explained Buckley, "and you can't see what their legs or feet are doing."
He said sometimes anxiety shows up in the lower part of the body during an interview. If the mention of a person's name or an issue makes the subject uncomfortable and he bounces his leg or fidgets, the interviewer should pursue that line of questioning further.
Buckley recommended that the interviewer minimize distractions as well. "Make the interview as private as possible," he added. It is also important that the subject sit close to the door to remove any perception that he is being detained in any way.
The amount of space between the subject and interviewer matters as well. Buckley identified four different zones surrounding an individual:
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- Intimate zone — within 1.5 feet of a person.
- Personal zone — extending from 1.5 to 4.5 feet.
- Social zone — extending out 4.5 to 12 feet.
- Public zone — over 12 feet from a person.
The ideal distance between the interviewer and the interviewee should be somewhere between 4.5 and 5 feet — between the personal and social zones.
Listening goes beyond just what is said to the content of the words used, as well as the pitch, speed, clarity and tone. A change in how quickly a person speaks should be followed up on further. Buckley said that people who use contractions are probably being more honest than those who need to enunciate each individual word to make their point.
Deceptive people will also use phrases to bolster their story such as:
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- I swear to God.
- As God is my witness.
- I'll swear on a stack of Bibles.
- I swear on my mother's grave.
- Honestly.
- To be perfectly honest with you.
Related: As insurance fraudsters get smarter, so do investigators and their methods
Gestures should match what the subject is saying if he is being truthful. (Photo: iStock)
Denials without words
Not every response has to be verbal. An interviewee can be evasive or delay answering a question. Repeating the question asked is the number one stalling tactic used. Clearing the throat or taking a drink of water are other ways to delay answering to give the subject a chance to formulate a response.
Sometimes a subject will use a gesture instead of words. The individual may not be outright lying, but gesturing allows the interviewer to draw certain assumptions, correct or not. Gestures can also be tension-relieving activities for a subject such as wringing the hands, scratching one's face, stroking or pulling the nose or earlobes, or picking invisible lint from a sleeve.
An individual who leans into an interview is probably being truthful. Putting a hand over the face, averting the eyes, mumbling or looking uncomfortable during certain questions may be indicators of deception or areas that deserve further investigation.
Buckley identified four behaviors that can be truthful or deceptive: being nervous, fearful, angry and quiet. Establishing a baseline for a subject can make it easier to determine if different behaviors are indicative of fraudulent responses. Truthful people are usually composed, concerned, cooperative, direct, open and sincere. Deceptive individuals tend to be overly anxious or completely unconcerned, defensive, overly polite, evasive, complaining or guarded. They may either slouch in a chair or hold their bodies in an unnaturally rigid or immobile position.
How good an individual's memory is of a particular day can also be an indicator of whether or not the person is telling the truth. Most people can't remember what they did six weeks ago at a certain time with any specificity unless it was a special occasion or they committed a crime.
Listening for what isn't said and how a person reacts to a specific line of questioning, as well as following your own intuition can be indicators of what to pursue during an interview. There isn't a magic formula to uncover the truth, but these tips can help give investigators a head start.
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