What is an Insurance Fraud Investigation?

Insurance fraud has become a massive issue in many parts of the world, more massive than you may have imagined. As insurance policies are made more rigid, the persons who commit insurance fraud become progressively more creative. While the most common of scams is pretending that an expensive item was lost and then filing an insurance claim, others have gone more daring by actually staging accidents. Some have gone as far as encouraging vehicular accidents in order to fake an injury. There are those who go into great lengths in forging vehicle title for a fictional but very costly luxury vehicle and then report the car as stolen and file an insurance claim.

An insurance fraud investigation is an in depth research done in order to determine whether a person or several persons are filing false insurance claims or not. The inquiry is usually done either by an in-house detective, or if the gravity warrants it, an outsourced insurance investigator. In some cases, it may also involve state law enforcement people. The common objective in these investigations is to establish what happened, if it was legal or not, and the people who are accountable for what happened.

Based on a worldwide survey, almost $80 billion is spent every year in payment of false insurance claims. This rise in falsified insurance claims may have a direct effect on everyone. First off, it makes insurance companies more cautious when paying claims and this can delay the process of handing out your insurance benefits even if your claim is valid. There may even be a need for you to seek professional help in making your claim which translates into additional cost. An insurance fraud investigation is done to know if your claims are false or valid. These investigations are usually performed if the insurance company has doubts on the claims that they are assessing.

Aside from being damaging to insurance firms, which stands to lose a lot of money in paying out fraudulent claims, fraud also hurts everyone who gets insurance. Insurance companies raise their premiums in order to compensate for the potential losses, something that they have already computed. The government is also affected whenever someone files fraudulent tax documents, or when another burns an establishment to collect fire damage insurance. In this particular case, the government has to respond in the personality of the fire department, and this wastes public resources.

Insurance adjusters usually recommend insurance fraud investigations when it seems that the case they are evaluating is suspicious. There are tell-tale signs when a claim is fraudulent and it includes the lack of key information, conflicting reports, and a lot more. Once fraud is detected, the insurance company may alert law enforcement informing them that someone is under suspicion. During the investigation, the fraud investigator may perform surveillance, gather information from the scene, talk to various experts, and ask law enforcement resources for assistance.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

What is a Private investigator?

Private investigators carry out secret enquiries and play an important role for their clients to find out information and check facts. Their clients include the legal profession, councils and insurance companies and can also include private companies and individuals. This work must be carried out with the highest degree of confidentiality, prudence and professionalism. The private investigator must be relied upon to maintain an ethical perspective without sacrificing performance or quality.

A private investigator’s work range from personal issues, for example divorce, to company issues, like suspected theft. They often do background research, which may involve asking questions and analysing information. The work may also include, surveillance, fraud investigation, tracing missing people or pets, handing legal documents to people, investigating commercial piracy and background checks on employees.

Many private investigators spend time away from their offices conducting interviews or doing surveillance in the field, but some work in their office most of the day conducting computer searches and making phone calls. When the private investigators are working on a case, the environment might range from plush boardrooms to seedy bars.

Private investigators often work irregular hours because of the need to conduct surveillance and contact people who are not available during normal working hours. Early morning, evening, weekend, and holiday work is common.

Regulations are in place where private investigators are require to have completed recognised training and are licenced before operating as an investigator. Private Investigators in Australia must be licensed by the licensing authority relevant to the State they are located in. This applies to all States except the Australian Capital Territory. Companies offering investigation services must also hold a business licence as well as all operators holding an individual licence. Generally the licences are administered and regulated by the State Police, however in some states this can also be managed by other government agencies. Investigators must remain in compliance with local and federal laws ensuring that all evidence acquired during those investigations can and is admissible in a court of law.

Often times, private investigators have worked in an enforcement or investigative role before working in this field, for example, in the police or armed forces.

The skills, interests and qualities a private investigator must have are: good spoken and written communication skills, excellent observational skills, strong analytical skills, self-confidence to present information in court, basic computer skills, a knowledge of the law, honesty and integrity, the ability to work independently, a logical approach to the work, patience and perseverance and empathy with clients who may be distressed.

For the most comprehensive information so you can make the best possible informed decisions regarding investigative services contact the professionals at Seca Investigations.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

What is Accidental Injury?

There are many types of accidental injuries. They include injuries sustained in auto accidents, drowning, injury due to whiplash, falls, sports injuries, burns, injuries incurred while using machineries, suffocation, accidental eye injuries, occupational injuries, toy-related injuries, and a few more.

Statistics show that one of the most common causes of injury is automobile-related accidents. Even the simplest fender-benders can lead to undetected injuries that can develop into headaches, pain, and even arthritis. A lot of people who have been involved in car accidents are not aware that they were actually hurt. Professional injury doctors, after a thorough examination, will be able to determine if there is any form of injury. In fact, it is smart to have yourself medically checked right after a vehicular accident however insignificant the accident may be. The doctor can recommend the necessary procedures in order to restore mobility.

Even in minor collisions, your body can still suffer from considerable trauma. Most accidental injuries in road mishaps can be considered as minor injuries which mean that they are not life-threatening. However, this does not automatically mean a person who figures in an auto accident with only minor injuries will not experience any lasting effects. In reality, even the most minor accidental injury can lead to long-lasting pain and suffering and which means reduced life enjoyment.

Whiplash or injury to the neck is a common car accident injury that can occur even at slow speeds. This usually happens when your car makes an abrupt stop while your body is still in motion. At this point, the seatbelt immediately puts a stop to your body’s movement, however the neck snaps forward and back. Though whiplash takes only a second to happen, the after-effects can be excruciating and long-lasting which makes it very important to seek medical attention when you feel even the slightest signs of whiplash injury. More than half of those who had whiplash injury suffer from and tightened muscles, as well as pain that emanates from the shoulders down to the back.

Other accidental injuries include damage to the knees, chest cavity, and bruising of the internal organs. These areas are susceptible to injuries in a car crash. The ankles can also be part of accidental injuries when seats move brought about by the collision or when the interior caves in.

Spinal injuries are the most common type of injury in traffic smash accidents. In car collisions with speeds going more than 60 kilometres per hour, trauma and injury to the spine is almost definite.

Because accident injuries can happen when you least expect them, it would be heartening to know that you can afford to take a break to recuperate, and this is where you need a dependable accidental injury insurance coverage.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

How to Deal with Workplace Bullying and Harassment

Workplace bullying is a big deal. When people think about bullying most of the time the first picture in their mind comes as high school students or something to that effect. That is not always the case.

Workplace bullying happens a lot more that people may think. Yes, adults bully too. As a matter of fact, this is oftentimes where the school bully’s learned their behavior from. So, how do you deal with workplace bullying and harassment should you find yourself a victim of or a witness to it?

If you are witnessing the behavior and you do not speak up then you are as guilty as the bully. This is your business; it is everyone’s business. With the violence that is prone to arise without warning in the times that we live in there should be zero tolerance for behaviors like these. Bullying is a sign of more serious underlying issues. It is certainly not stable adult behavior!

Workplace bullying can be defined as any repetitive behavior intentionally done to embarrass, control, hurt or intimidate a coworker. This behavior can come from a peer or an authority in the company.

Regardless of whom that bully is or what their statute, bullying is wrong. When someone bully’s others, they are actually taking pleasure out of causing pain that should be considered as a serious warning sign of potentially dangerous behaviors being possible.

Oftentimes the deep seeded physiological issues that a bully has are control related.

Watch for things like shouting, name calling, disrespectful comments, belittling, nitpicking, excessive monitoring and constant criticism as these are sure sign that you are dealing with a bully. Things like overloading someone with responsibilities and setting them up for failure can also be forms of workplace bullying.

Know whether or not you are being victimized, and do not tolerate it in silence! Bullying at work can cause you issues at home. You may find that your sleep and appetite patterns are thrown off, you may suffer depression and anxiety or even become suicidal. You do not have to live as a victim. Taking a stand starts with facing the fact that you are being bullied and telling your bully to stop.

You will also need to keep a journal, and get witnesses as well. You want to approach a higher authority with a clear head and solid proof that the bullying is taking place. Then you are no longer a victim, and you can start the recovery process as a survivor of workplace bullying.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

Infidelity Investigations

Have you considered matrimonial investigations service? Although matrimonial investigation companies are nothing new, surprisingly, many people today are still unaware of the valuable service they provide to brides, and grooms. If you or someone dear to you hasn’t ever considered investigating a suspected unfaithful partner, male or female, then you might regret it later. Why hire a matrimonial investigation company?

Benefits of Matrimonial Investigations

Countless individuals have benefited from utilizing matrimonial investigations. The most common reason why people hire private investigators is simple; they suspect that their better-half is being unfaithful. There are others reasons; suspected past criminal history, misuse of financial assets, child support, prior swindling activities, prior marriage or a violent history.

Sad, but true, most people with a blemished past try to hide it. It is unfortunate that we don’t live in a perfect world; however, people today have greater access to investigative services than ever before. Instead of always suspecting a cheating partner, now you can discover if they are truly innocent, or not. In this way, hiring matrimonial investigation services can provide the evidence you need, before you actually confront them. Some of the services a private investigation agency can offer are listed below:

  • Divorce Settlement
  • Child support
  • Background Check Prior to Marriage
  • Commercial/ Business Verification
  • Family Law
  • Proof of Cohabitation
  • Surveillance and Investigation Fact Finding (photograph or video)
  • Observing Teenage Activities

Utilizing matrimonial investigation services just makes sense, especially when it can provide the peace of mind that you deserve. Professional surveillance operatives are skilled at being discreetly covert during their investigations and surveillance activities. All surveillance activities are recorded in great detail and are very accurate. The information and evidence obtained during partner investigations and matrimonial investigations are strictly confidential. When should someone need to use matrimonial investigations?

Noticing Suspicious Signs in Behavior

There are many tell-tale signs to look out for. The behavior of a partner or spouse can reveal a lot, however, behavior alone can’t provide proof of infidelity. If your other-half is spending more frequent time away from home, they are working later and later more often, they use the phone more when you are not around or won’t always answer their phone, then you should consider matrimonial investigations provided by a professional private investigation agency today.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

What is an Origin and Cause Investigation?

Origin and cause investigation, also known as fire investigation is the analysis of any incident that is fire related. On the whole, after a fire has been extinguished, there is an investigation to determine the origin and cause of the said fire. As well, origin and cause investigations include explosions.

This type of investigation is comprised of a systematic scientific approach and the understanding of basic fire science. With a distinctive law enforcement investigation that includes a fire or explosion, a fire scene investigator and laboratory analyst will be at the scene.

An origin and cause investigation is to determine if a crime has been committed. The fire investigator must have knowledge of fire dynamics and fire chemistry in order to make an accurate analysis. Fire scene investigators can be certified through the National Association of Fire Investigators (NAFI) or the International Association of Arson Investigators (IAAI).

A fire investigators systematic scientific approach should include:

  • Accepts the investigation and all responsibilities
  • Plans the entire investigation
  • Brings together needed tools, equipment and personnel
  • Thoroughly inspects the scene and collects data
  • Gathers, exams, assesses and documents all evidence
  • Applies scientific methods in order to analyze information that is gathered

In the United States, a fire investigator oftentimes refers to the NFPA 921: Guide for Fire and Explosion Investigations (National Fire Protection Association). The NFPA 921 standards set the bar for scientific-based analysis and investigation of fire and explosion instances.

When are Origin and Cause Investigations Needed?

Origin and cause investigations are needed to determine if the scene was caused by arson or other factors. A thorough investigations report is oftentimes used in general insurance investigations. Certain investigations may be helpful for a variety of reasons:

  • Large loss investigation
  • Arson fraud Investigation
  • Insurance and arson claims
  • Computer in fire investigation
  • Property insurance loss register

Complete Investigation Services

A complete origin and cause investigation service should have important key features that they provide for a client. A professional company is meticulous and continually up to date on current legislative and industry changes. A business that has an experienced and educated management staff can provide high quality and timely reports for their clients. This ensures that the client can validate a claim and the conditions surrounding the origin and cause.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

When should you hire a private investigator?

Knowing when to hire a private investigator is important. Since it is not an everyday occurrence, it may be a difficult and formidable decision. Most people have no idea where to begin or if they really need to hire investigative services. However, identifying certain criteria and factors can be very helpful.

Track Down Assets

Tracking down assets plays a big part in many divorce cases. A private investigator may be needed to track down all hidden assets such as bank accounts, real estate, stocks or bonds. This type of investigation is very helpful, especially when the spouse claims to be living in poverty. Furthermore, it may help in getting your money back.

Background Check

When you own a business it is important to hire investigative services so they can do a thorough background check on potential employees. A background check is imperative, especially for jobs that entail handling private information such as an accountant, nurse, nanny or other significant positions.

According to a recent survey by Forensic Psychology, 31 percent stated that they lied on a resume. As well, research collected by Jobacle (a career advice blog) suggests that it is 43 percent, resume lies included:

  • Salary: 27 percent
  • Job responsibilities: 19 percent
  • Job skills: 17 percent
  • Job performance: 15 percent
  • Credentials: 12 percent

Corporate Complications

Whether you own a large corporate firm or small business, there can be enormous responsibilities along with many issues. Investigative services can help a variety of business complications such as embezzling or espionage. A private investigator can track down the problem and help with resolution.

Find Missing People

It is important that investigative services are used when someone is missing such as a teenager, birth parents or a distant relative. For instance, at times the police are not able to locate a missing teenager or child. Sometimes hiring a private investigator is the best chance of finding a missing person.

Uncertainty

If you are still unsure about hiring a private investigator, chances are that they can give you consultation. In fact, some investigative services offer an initial free consultation. Moreover, a licensed investigative service will conduct investigations in a lawful manner plus provide services that are completely confidential.

Before hiring a private investigator, make sure that they are licensed and qualified. You can also call the states private investigations licensing unit to see if there are any complaints submitted, if the business has been suspended or sanctioned. If your research about the company is good, then you can be rest assured and confident in knowing their investigative services are outstanding.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

Understanding CLAIMS INVESTIGATIONS

Do not get nervous, it’s standard procedure to be investigated if you make a claim.

Even with help and representation this can be one of the most overwhelming times if your life. There is a lot of red tape, and it can get quite confusing. Here we will try to break it down a bit, and if you have questions still there are always professionals standing by to help you through.

Understanding claims investigations regarding disability and income protection, for most, can mean having or getting a legal degree. Legalize has never been easy for the layman. For those of us without a legal degree and no plans on getting one, we need to rely on trusted sources that cam help with our claims.

The claims investigations process – Do you have disability and income protection?

If you have disability and income protection and are making a claim you need to know the process. Typically the process calls for a claims reviewer to investigate a long term temporary or permanent disability. You should know upfront that claims investigations are common.

A claims representative will:

  1. Give you a call to ask questions. Don’t be nervous, just tell the truth to the best of your knowledge.
  2. Request medical records. This is customary. Without substantiating medical records you won’t be able to prove a claim.
  3. Background investigations will likely be performed.
  4. Background interviews may also be done by:
    • Interviewing your friends, family and even your neighbors.
    • Obtaining substantiating employment records.

The claims investigator will need to know all the details of regarding your claims investigation.

There’s really nothing you can do if you are the one filing a claim to keep from being investigated. This type of disability income protection is expensive. The more claims filed, the more expensive it is on employers.

No doubt the employer or the insurance carrier will fight with all their might, to keep from paying out claims. Some policies even state that investigations are mandatory.

If you are somehow required to have a medical examination then by all means cooperate. You can request an audio recording be done during any examinations. This way you also have records from the claims investigation that could help your case. If the doctor or examiner refuses this stipulation have them put it in writing. However, in most cases the claimant cannot refuse. Yes I know, it seems like a double standard to me too, unfortunate but reality nevertheless.

You may never meet the examiner in person but you can be assured you will be speaking. Again, if you have questions regarding a claims investigation do not hesitate to ask. We are always here to help.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

Understanding CLAIMS INVESTIGATIONS: Workers’ Compensation claims

Information for employers and employees who are struggling with a claim.

For employees

Worker’s compensation claims literally re-injure the employee all over again, and in some cases the family unit is hurt as well. Not only does the injured worker have to endure the physical and or emotional pain of his or her injury, they may have to deal with a long drawn out worker’s compensation claim as well as the litigation that, in many cases, go along with it. You are not alone, and getting an attorney may be the best thing that you can do.

Look for attorneys who only get paid when you win your case. There are a lot of those operating across the country, and they are adamant about getting your case won. You will fair far better with a private attorney than you will trying to go it alone. It is totally worth the fees they charge, and it can literally mean the difference of thousands of dollars bring put back into your bank accounts.

Typically worker’s compensation claims are filed by the injured party through his or her employer. The claim gets escalated to the insurance carrier or an employee who is designated to handle the worker’s compensation cases and files that the employer is required to maintain. It can be a grueling process, and nothing about it works fast.

Employees filing workers compensation claims get worn out from waiting months upon months, maybe even years, to get the final settlement. They find themselves living hand to mouth on nothing more than their savings, credit cards, monthly payments or subsidies.

If the injured worker is the bread winner you can imagine the devastation on the family unit and their finances.

If you hire an attorney you won’t have to deal with the insurance companies anymore. You have to be very careful, because they will set you up to be denied. You want to let your attorney be the one speaking to them and handling the mail from them. Remove yourself from the litigations process. Your money will come more abundantly and much faster.

The companies insurance will make any claim possible to discredit a person claiming injury in the workplace. So, don’t do any difficult tasks, yard work or heavy lifting because the pictures will show up in court in a feeble attempt to prove that you can work or that you aren’t injured.

Employers have rights too.

On the other hand, many an employer has been scammed by wrong doing employees who simply want a big, a huge pay day via a workers compensation claim or a law suit against the business that they currently work for. If you are an employer wanting to make sure that your employee isn’t trying to pull a fast one then surveillance will work well to get the proof in print and or video.

Not everyone claiming they have been hurt has really been hurt. This is one reason for the high price of insurance these days, fraud! Fraud causes everyone to pay a bigger price. If you are an honest employer than can’t provide solid proof against an employee claim then hire a private investigator and get the goods on the no-good employee. It’s never ok to commit fraud. If an employee did indeed try to scam an employer and files a false claim then he or she deserves to pay the price.

The employer has the insurance companies who will investigate the fraud claims, but if that is not working then you need an attorney. However, if the claim is legitimate you will end up having to pay them their dues, so trying to fight it will only lead to your having to spend unnecessary funds. It is best to go ahead and offer them a settlement and get through the process as quickly as possible.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980

How to deal with sexual harassment in the office

Understanding, what is sexual harassment will help you to know how to deal with sexual harassment in the office, if it ever occurs. Unfortunately, unwelcome sexual attraction can come from anywhere and can make a person feel intimidated, humiliated and offended, especially if it occurs in the workplace. What is considered to be sexual harassment, how to identify it, and how to deal with it is not as difficult as some may imagine. Let’s have a look.

What Constitutes Sexual Harassment?

Any unwanted words, action or physical contact that has a sexual connotation is considered harassment. Here is a simple list of types of conduct which are legally viewed as sexual harassment in Australia:

  • Unwanted kissing, hugging or touching any part of the body other than the arms
  • Constantly leering and staring
  • Jokes and comments with suggestive undertones
  • Being shown sexually explicit pictures
  • Sexually degrading comments meant to taunt or insult
  • Emails or SMS messages that contain sexually explicit words or content
  • Stalking or exposing one’s genitalia to another

If you have experienced any one of these at least once, or on a continuous basis, then you have been sexually harassed and should seek the advice of a private investigator. Even if you are accused of sexual harassing someone, a private investigation company can help you to prove your innocence. But what steps should you take in the meantime? Try approaching your supervisor, manager or the owner of the company, and explain what is happening to you. If you find no support, then there are other measures you can take.

How to Deal with Sexual Harrasment in the Office

If you are convinced that you have been, or are being, sexually harassed by someone in your office or workplace and you don’t know how to deal with it, take courage because you can do something to stop it. One thing you shouldn’t do is nothing. Don’t keep quiet about it and think it will just go away or the person will stop.

Unfortunately, that probably won’t happen. Instead, you should try to record or collect any evidence you can that would prove you’re being harassed at work. Why? Because, at the end-of-the-day it will be your word against theirs, and witnesses are usually more afraid of losing their employment than seeing justice done.

An Investigative Service can help You

An investigative service can help you deal with sexual harassment in the office. How? They can assist you in gathering accurate information by interviewing potential witnesses to support your sexual harassment claim. Private investigators have experience in sexual harassment cases, and can recommend attorneys that can help you defend yourself, especially if you are falsely accused of sexual harassment.

If you have tried speaking to your supervisor, manager or the owner of the company, to no avail, then the best way how to deal with sexual harrasment in the office would be to seek the assistance of a professional investigative service.

Seca Investigations:
Phone 61 3 9544 6865 / 61 3 9544 8279
Fax 61 3 9558 8980