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.

Employee Ethics & Fraud During COVID-19

Back in April we wrote about fraud predictions during the COVID 19 pandemic. Back then most of what was out there was PPE (Personal Protective Equipment) fraud. We saw a lot of fakes and it even began to show up in COVID testing. Much of this was controlled by the FDA who provided consumers with updated information on their website on a regular basis.

Once the government released stimulus checks, the scams began. Scammers were contacting people through email, telling them that their check, as part of the stimulus package responding to COVID-19, is already waiting for them and that all they need to do is to provide personal information. This included bank account numbers and Social Security Numbers, which are the key pieces of information needed to perpetrate identity theft.

 Bruce Dorris, J.D, CFE, CPA, President and CEO of the Association of Certified Fraud Examiners, explains that in the current conditions, we can expect to see a number of long-lasting implications. One important one being an explosion of fraud in the coming years — and organizations need to brace themselves.

Corporate Employee Misconduct

Some of our corporate associates have expressed concern with what lies ahead as they navigate the uncertain waters of the Pandemic. One company in particular needed to shut down an entire plant because an employee tested positive for COVID. The employee presented the company with a falsified COVID 19 medical claim. He went as far to provide an excuse letter from a medical facility appearing to corroborate the test results. In concern for its employees and customers, the company closed its facility for cleaning and paid its employees during the shutdown. This caused a loss in excess of $100,000 to the corporation and the unnecessary quarantine of several of the defendant’s coworkers. He is now released on $15,000.00 bail awaiting trial.

FBI Recommendations

The FBI has recommended that companies be particularly alert during the pandemic about possible fraudulent work excuse letters, as they are finding more people attempting to exploit the situation for personal or financial gain.  Submission of a medical claim proven to be false could lead to criminal penalties, including fines or imprisonment by U.S. federal and other authorities.

What This Will Mean for the Private Investigator

Investigation around employee misconduct is an area that could prove to be quite lucrative for investigators. ABC News in Phoenix, AZ did a story on how local investigators are getting calls from corporations to check up on employees who should be working from home. This is not an isolated incident.

I believe we will see more and more fraud cases such as this over the next year if not longer.

How to Catch a Cheater: The Web & Infidelity

We see our fair share of infidelity cases in which a Private Investigator wants to conduct a deep web scan on the person accused of cheating. This is always a mixed bag for us because there isn’t any software out there than can pull any or all data from dating sites. Most dating sites are password protected sites and require the user to have an account in order to search. And sometimes it is even hard to search when you have set up a fake account.

If you are willing to take the time to set up fake accounts, it may be worth it in the long run. This is especially true if you take on cases like this. You may even find it helpful in other online investigations too. Here is how.

Dating Sites

Match.com

  1. Must have an account to search.
  2. Create a fake account to get started.
  3. Change your settings so you can be invisible and therefore not be able to be “searched”.

From there you can search. This is a great place to start any OSINT investigation because if a person is on a dating site, chances are they will be much more open there. You may be able to gather quite a bit of information that will help you locate your target on other sites, such as social media.

There are a lot more photos. Most people on a dating site want people to see them and therefore you will have more to go on.

Ashely Madison

Ashely Madison was hacked in 2015. Back then, hackers calling themselves the “Impact Team” stole 32 million records from users of the world’s leading extramarital affair site. As datasets go, this is one that’s tailor-made for extortion. Many people claimed to have the data dump, most proved to be untrue. I would bet that it made its way to the Dark Web however where information could be obtained for a fee and used in extortion cases. This one may be worth creating a fake account in. If you are not aware, it is designed for people who are married, but are looking to have an affair.

Meetup.com

This site is not exclusively used for dating. There are many different types of groups based on a particular interest. It may be a good one to dive into if you know some personal information on your target. For example, is your target a musician? There may be a group for that locally. It may seem like a long shot, but if you have the time, it could be worth the effort.

What About the Deep Web?

Diving into the deep web may help us to find a breadcrumb that could lead us to information that can help in surveillance. It may be a trend that is picked up relative to being part of the same forum, group or professional network. In cases like an infidelity case, the more data we have the better. One common thread, in discovering a cheating spouse, is the use of multiple email addresses. Try searching using all the email addresses because one of them just may be tied to a profile identifying the target. Almost any group or site online requires you to give an email address.

As you can see it is not always easy. While it may seem impossible, if you are willing to devote time to it, you may find what you are looking for.