Category: Litigation

The COVID-19 Fraud Storm Continues…

When we think of fraud due to the COVID-19 pandemic, we think of individual people committing fraud. After all we are only too familiar with workman’s comp insurance scams & most recently, employee fraud. We have discussed in a previous blog post how one Fortune 500 company had a loss of over $100,000.00 after an employee falsely said they were tested positive for COVID-19.

The story now continues with business fraud. Small businesses across the country have been nearly put out of business due COVID-19. Many have been able to stay afloat from government PPP funding. However, some are sadly starting to take matters into their own hands.

What the Experts Predict

Data analytics provider Verisk has alerted folks that COVID has created opportunities to commit medical billing fraud and abuse. In April, the company said its data reported a 14% increase in claims linked to suspicious billing practices.

Verisk said its Insurance Service Office MedSentry team has identified several COVID-19 medical billing schemes. Among them:

  • Unlisted lab tests. There was no specific ICD-10 code for COVID-19 until April 1. Prior to then any COVID-19 tests were likely coded as “unlisted laboratory tests.” Claims for a patient who has received both an unlisted laboratory test and a COVID-19 test may be cause for scrutiny.
  • Hands-on therapy charges. Many providers eliminated in-office visits and began to offer telehealth sessions. Verisk said bills for hands-on therapies such as chiropractors, physical therapists, and massage therapists should be examined.
  • Unnecessary durable medical equipment. Insurers should be wary of misleading claims for gloves, face masks, thermometers, and similar items, especially for patients who have not been tested for COVID-19 or have tested negative, Verisk said.

Social Media Monitoring

Work is being done to create a software that allows the user to find unapparent connections between all people in a claim to uncover potential scams. While it has a way to go in development, if created, it would be an excellent resource to help investigators identify potential scams and link the culprits.

Google Search – Trending

Google searches can be very revealing and a good indicator of what people are thinking of doing. The question, “How to Burn a Car” has increased 125% since January of this year.

setting car on fire

Not surprising, Google is showing some strong trending in Employment Fraud. The graph below shows Google trends over the last 90 days.

We will continue to report our findings during the pandemic.

OSINT Research: The Devil’s in the Details

For those unfamiliar with the term OSINT Research, it is explained this way by Wikipedia

Open Source Intelligence (OSINT) is the collection and analysis of information that is gathered from public, or open, sources.[2] OSINT is primarily used in national security, law enforcement, and business intelligence functions and is of value to analysts who use non-sensitive intelligence in answering classified, unclassified, or proprietary intelligence requirements across the previous intelligence disciplines.

OSINT sources can be divided up into six different categories of information flow

Open Source Intelligence

OSINT Resources Reveal the Details From the Deep Web

Many times our clients want to better understand the difference between a social media scan and a deep web scan. Taking a close look at the image above explains a lot and kind of surprises most people in terms of the data on the web that is openly available.

eChatter Case Study Examples of Deep Web Details

  • Recently, we were trying to find out whether a POI (person of interest) was married. He had no Facebook clues other than he was in a relationship. After conducting a deep web scan we found a local newspaper article in which he was named along with “his wife”. The wife chose to keep her maiden name.
  • A deep scan was ordered by a client to determine what happened to a deceased person’s body. We found an association letter that was published online indicating the person was cremated and buried at sea.
  • A client needed to know if their POI had any business affiliations that wasn’t disclosed in a divorce settlement. After a deep scan was conducted, we located quite a few businesses tied to the POI.

Does it always work out this way? Not at all. Mainly because some people are much better at hiding this than others or because they were advised to delete everything online by advice of counsel. However, these are the kind of details OSINT research is all about. You will not find this in a Google search.

Wait…Where Did That Social Media Post Go?

What happened to that social media post you saw yesterday during your recent online investigation? Are you kicking yourself that you did not capture that post when you saw it? It can happen and very often does. The old adage, what is here today, is gone tomorrow, is something that happens all of the time, especially in social media. It may suddenly be changed from “public” to “private” at any point. The user’s entire profile can be deleted at any time. Where will that leave you and your investigation?

Largent V. Reed

Back in 2011 this was not an issue as social media was just starting to grow. In a personal injury lawsuit, Largent v. Reed, the plaintiff claimed that a recent accident had left her with severe physical and mental pain. During the trial, defendants presented her post-accident photos posted to her Facebook profile. These photos revealed the plaintiff was clearly feeling well enough to engage in her daily activities and exercising at her gym on a regular basis.

Fast forward to 2020 and things have changed. People are more aware of what they post and use user names that are different than their real name. Let me give you a recent example. One of our clients requested a deep scan from us for a case that involved fraud. We conducted the scan and produced the report capturing the subject’s Facebook account. Scans include live URL’s as well as screen shots showcasing all publicly available data. Once given to the attorney, he had a question about one of the posts specifically. When attempting to click on the link within the profile post, he came to a dead end. We did capture a screenshot, which in most cases is sufficient for investigative purposes. However, time is critical when conducting this type of research. Looking a little more closely at one of the posts was no longer possible.

Web Preservation

Preserving digital data is something many attorneys are starting to take a serious look at and in some cases are requesting from their private investigators. Judges are getting stricter when it comes to allowing social media as evidence in court. Not all cases make it to court of course, but preserving social media may be that extra step that your clients may want you to take.

Social media posts can be altered quickly, often at the advice of opposing counsel. Be sure not to wait too long to capture the data you need and in some cases, be sure to preserve that data.