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I-Spy: How Social networking is impacting claims investigations
 

I-Spy: How Social networking is impacting claims investigations

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    I-Spy: How Social networking is impacting claims investigations I-Spy: How Social networking is impacting claims investigations Presentation Transcript

    • Sedgwick © 2013 Confidential – Do not disclose or distribute.I-Spy:How Social Networkingis impacting claimsinvestigations
    • Sedgwick © 2013 Confidential – Do not disclose or distribute.VINCENT P. VOSSEL FCLAManager Client Services, SIUSedgwick Claims Management Services, Inc
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 3I-Spy, social networking History Most Powerful Investigative Tool: Social Networking Available Information Impact of Social Networking on Investigations The Value of Using and the Cost of Not Using Social Media Impact on Claims Handling Legal Concerns Case examples
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 4I-Spy, social networking• History of SIU and use of social networkingTraditional SIU• Investigate identified potentialfraud• Claim cost savings• Reactive approach• Dependent on the examiner toreach outThe New SIU• Creative new approaches toidentifying fraud• Investigation worked from adesk before any field• Claim expense reduced• Calculated approaches• Earlier detection – more costsavings• Timely return on results andupdates electronically
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 5I-Spy, social networking 1995 – General public obtains access to the internet AOL, CompuServe and Prodigy begin dial-up service (14.4), Amazon launched, BillGates called the internet a “passing fad”. 1998 – Google 2003 – MySpace, LinkedIn 2004 – Facebook 2005 – YouTube (Now owned by Google) 2006 – Twitter micro-blogging site 2007 - Apple iPhone 2010 – Apple iPad, Google Android, Smart phones 2011 – IBM’s Watson on Jeopardy 2012 – wi-fi hot spots – mobile phone chargers
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 6I-Spy, social networking• Term, Social Network, was coined in 1950• Will continue to increase information and accessibility to information• Ever changing: It has changed the way we as a society interact• Done by creating “profiles” and posting blogs, text, images, videos, etc.• Provides information which make field services more useful andtargeted.• Social Revolution
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 7I-Spy, social networking More than 20 million hours of video wereuploaded during 2011 and over 48 hours of videoare uploaded every minute. Over 3 Billion views per day More video was uploaded to YouTube in 60 daysthan the three major networks created in 60 years. 70% of YouTube traffic comes from outside the US. YouTube reached over 800 Billion playbacks in2011
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 8I-Spy, Social Networking
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 9I-Spy, social networking• Social Network Technologies Photo Sharing Email Blogging Video Micro blogging Topical Chat Pages Instant Messaging Texting
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 10I-Spy, social networking• Most Popular Social Sites 2013• Facebook• Twitter• MySpace• LinkedIn• Ning• Tagged• Classmates• Hi5• myYearbook• Bebo• Tout• babe• mylife• Friendster• tumblr• Multiply• orkut• badoo• gaia online
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 11What’s Hot
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 12What’s Not
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 13Social Networking Pages A typical social network page contains over 30 pieces of personalinformation to include the following: Name DOB Political direction Religious beliefs Address Friends family Sexual preference Relationship status Favorite books and movies Movies Educational background Employment history employer Pictures Other interests
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 14Photo SharingPhoto Sharing Sites Flickr Photobucket imageView Smugmug Shutterfly Postimage Webshots ImgurPhoto Sharing Websites for Twitter usersInstagram Flickr Mobypicture Tvider Twixtr Ow.lyTwitpic Yfrog
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 15Geotagging• Geotagging is the process of adding geographical identificationmetadata to various media such as photos, video, websites, textmessages or RSS feeds and is a form of geospatial metadata. This data usually consists of latitude and longitude coordinates, though theycan also include bearing, distance, accuracy data and location names. This ismost commonly used with Photographs. GPS enabled smart phones anddigital cameras will geotag photoswhen taken through those devices.(EXIF image file)
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 16Metadata• Metadata is data about data. descriptive statistical information aboutthe elements of a set of data. This hidden data is used by computerprograms and sites to accurately process information. i.e. How is itencoded, software.
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 17“Checkin” posting sites (Foursquare and Gowalla) These are mobile applications for users to connect with “friends” andupdate their location by “posting” or “checking in.” Users must register at the sites. These sites record the users activitiesand postings from thereon. The sites were originally launched in 2009 with limited availability for“checkins.” In 2010 Allowed “checkins” world wide Spring 2010 500,000+ users Fall 2010 3,000,000+ users Spring 2011 over 10 million users Currently over 4,000,000 checkins daily
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 18What is the value in Checking these sites? Multitudes of information can be gathered on specific subjects andtheir activities. Social media “Ego Trip“. People love to promote themselves thesedays. # of friends Photos Where they are Self promotion for many activities on local periodicals or websites Pattern of habits and activity Helpful in determining location and obtaining updated photo Marketing of self or products
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 19The Value of research and Cost of not using it first To take advantage of the “Technology Multiplier” Right Functions to Right Resource Benefits: Maximize SIU results by proper use of resources Most requests for SIU services are informational Claim cost savings Desktop investigation and analysis Field Investigators focus on investigation Better understand the costs of investigation
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 20Pre-Surveillance address check• Residence address provided by Claimant:15275 COLLIER BLVD, APT #201NAPLES, FL 34119
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 21Social Media results and insurance investigationsVerifying policy application informationVerifying facts of reported lossAlibi for the claimant or insuredChecking claimants activity to verify disabilitystatusLocating a claimant for surveillance orinterviewIndentifying witnesses
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 22Case Study: SNS Success RateSuccess by Personal Info (Age):For all cases reviewed:Overview all files (all ages):% of files with zero (0) hits ( 6%)% of files with at least one hit (88%)% of files with only phonebook registry/spokeo (6%)% of files with 2+ hits (81%)% of files that information useful (65%)Success by Personal Info (Age):% of files where subject is 34 or under with one or more hits (87%)% of files where subject is 35 or older with one or more hit (89%)
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 23The SourceSocial Network Engines Snitch.name Googleblogs Kgbpeople WhostalkinPeople Finders Peekyou Pipl Spokeo Webmii ZabasearchEbay/craigslist Searches Ebay advanced search Searchtempest.comDatabases LexisNexis ISO APEX TLOPublic Records Publicrecords.com Accurint Real Search State sitesBusiness/Assets Dunn and Bradstreet IRB State DMV Property.com LexisNexisRelationships State Fraud Bureaus Attorney Generals office NICB CAIF States AttorneyDistricts Attorney
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 24Why pay for searches when it is online and free?What sites to searchUnderstanding laws and site policiesMonitoring on a regular basis –SearchesCapturing evidence
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 25Proper Chain of Custody• Evidence PDF screen shots (grabs) Screen print outs Webcopiers Rip video Potentially using evidence that could be used in a court of law
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 26Privacy Terms of Service• An estimated 77% of SN users don’t read their sites’ privacy policies.Consequently, many are unaware that much of their postedinformation is public. SN sites make it clear that information posted to them may be shared with others ormade available to search engines. End-User License Agreement (EULA) is a legal contract between themanufacturer/author and end user of an application/software. Some of the contentyou share and the actions you take will show up on your friends’ home pages andother pages they visit. Even after you remove information from your profile or delete your account, copies ofthat information may remain viewable elsewhere to the extent it has been shared withothers, it was otherwise distributed pursuant to your privacy settings, or it was copiedor stored by other users. You understand that information might be re-shared or copied by other users. Certain types of communications that you send to other users cannot beremoved, such as messages.
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 27Legal Concerns Using Avatars or “fake” online personalities Communication with the claimant and “entrapment” Duplicated information for trial – proper preservation of evidence Association to the claim may hinder information usefulness. Know the legal ramifications for obtaining surreptitious information Obtaining information and preserving evidence correctly can result in asuccessful claim handling or legal proceeding.
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 28Fraud Conviction
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 29Fraud Charges
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 30YouTube video triggers fraud charges
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 31Case Example• Injury: PTSD as a result ofseeing a crane tip over and killthe occupant.• He is unable to work due tohis emotional state of mindand not being able to focus.• Date of Loss: 8-16-2007
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 32
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 33
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 34
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 35
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 36Surveillance results
    • Sedgwick © 2013 Confidential – Do not disclose or distribute. 37Surveillance results
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 38Sedgwick - SIU“I only relax and heal on my time off…”Injury: left knee sprainDate of Loss: 4-30-2012Client received tip that the subject may beactive on weekends.
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 39Sedgwick – SIUOur FAST results showed the followingactivity:1He plays for the Stallions of Country ClubHillshttp://www.stallionfootball.net/Leagueinfo www.gmfleague.comClaimant islisted as #48Last game was 7/28,The nextgame is 8/4 at 4410 W. 175th St.,Country Club Hills, IL
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 40Sedgwick – SIUSocial Network review:
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 41Sedgwick – SIUSocial Network results:
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 42Sedgwick - SIUOur investigative results:
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 43Sedgwick - SIUOur Surveillance results:
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 44Sedgwick – SIUInjury:Carpal TunnelDescription:“I can not grip my handswithout constant pain shootingthrough my arms…”Date of Loss:2-10-2011
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 45Sedgwick – SIUOnline search results showed he recently purchased abed and breakfast in Michigan. He was hosting visitorsand available for snowmobile tours and repairs onsite.
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 46Sedgwick - SIUWe decided to take guided tour with the claimant asoffered:
    • Sedgwick © 2012 Confidential – Do not disclose or distribute. 47Sedgwick - SIUWe spent three days touring the countryside:
    • Sedgwick © 2012 Confidential– Do not disclose or distribute. 48Questions?