Monday, November 26, 2018

No-fault insurance fraud in Michigan: How they got caught

No-fault insurance fraud in Michigan: How they got caught
"Private eye Chris Charow has seen hundreds of instances of exaggerated injuries, faked injuries and outright fraud that contribute to Michigan's highest-in-the-nation auto insurance rates.
He photographs people who pretend to slowly limp across parking lots on their way to medical exams for no-fault insurance benefits.
Hours later, Charow, 47, will spy these same individuals appearing healthy and injury-free as they stroll supermarkets or move around their driveway at home. And the visual props that they pulled out for the doctor's office — walkers, canes, cervical collars — have disappeared...
...Caught at the amusement park
...In one case, a 34-year-old Sterling Heights woman claimed that she needed eight hours a day of insurance-paid attendant care, provided by her out-of-work brother-in-law, for devastating injuries from her car accident. The brother-in-law supposedly helped her get dressed, get in and out of the shower and even with the toilet, according to court documents.
The woman claimed that she couldn't walk more than 20 or 25 minutes without pain, and for enjoyment could only sit in her backyard and drink coffee or stay inside and watch TV.
Yet only weeks before her August 2015 deposition, an undercover investigator with Lexington-based Quest Research Group caught the woman traveling with a group to the Michigan's Adventure theme park in Muskegon.
She was photographed walking around the park for nine hours without any assistance and at times pushed a stroller. The investigator took video of her on the park's log ride, waving a hand in the air and bracing for the final plunge, court documents say.



She also went on the Sea Dragon ride and the Corkscrew roller coaster, infamous for its "dizzying speeds and endless loops that will turn you inside out," according to description on the park's website.
The undercover video was devastating to the woman's lawsuit, which had sought more than $25,000 in no-fault benefits from Safeco Insurance Co.
“It is impossible to believe that (she) was able to walk about an amusement park and ride roller coasters for nine hours, but just days later she was so injured that she needed help getting in and out of the shower and with toileting and getting dressed,” Michael Martinico, an attorney representing Safeco, wrote in court documents.
The woman later signed an affidavit saying that she never lied and that the surveillance video couldn't show whether or not she was in pain.
Her lawsuit against the insurance company was ultimately settled for $6,709, with Safeco paying some medical bills but not the brother-in-law's attendant care services, court records show.

...Time to get aggressive?

Charow, the private investigator, said he believes that more aggressive prosecution of insurance fraudsters could have a strong deterrent effect.
Right now, many individuals who are caught in schemes go unpunished. The worst that generally happens to them is their insurance benefits get cut off and they have to take settlements, he said.
"What happens when you catch somebody? They get a big settlement check and there are no criminal charges filed," Charow said. "Start putting some penalties on this and the fraud will slow down. That's how we're going to get it to be an affordable, honest system."...
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