Baiting the Rat Trap

Recorded statements and 'EUOs'

By Douglas Alba, Esq., and Jack S. Senechal, Esq.

Millie, a fraud examiner, was hired by a well-known insurance company once it suspected that an insured customer faked a serious back injury to file a claim and collect $1.5 million. The case was taken to court where Millie found the plaintiff sitting comfortably with his family during a one-hour recess. Using fraud examination techniques she had learned, Millie was able to catch the plaintiff in a lie. She questioned him in a way that led him to tell the court that his injury made it impossible for him to sit for long periods of time. Like Millie, you can learn how to bait a trap to catch insurance offenders before they claim more money.1 And the interview skills you'll acquire will help in all other types of fraud examinations.* 

In 2003, approximately 10 percent of all insurance claims paid nationwide were fraudulent. Though state and federal bureaus continue to post solid gains to prevent this, carriers cannot rely on the public sector alone to stand guard against this growing problem. Insurers must make their in-house anti-fraud measures a priority. The recorded statement and examination under oath (EUO) are the most important investigative tools available to the insurance industry for early detection of fraud or for building a case for denying coverage because of material misrepresentations or non-cooperation. If used effectively, these devices can lead the potential defrauder to his own demise like a rat to a trap. Fraud examiners of all stripes can use these tools to snare rodents in all areas of occupational fraud.

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