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David Morse & Associates Fraud Chronicles 6: Christmas Decoration Syndrome
For whatever reason, the person who is perpetrating fraud by making a bogus claim of being injured or disabled can often be "found out" at Christmas time. Often during the holidays a person falsely claiming to be totally disabled can be found carrying packages or a child, hanging decorations, or generally doing things that are inconsistent with his or her claim.
Investigative firms like David Morse & Associates (http://www.davidmorse.com) provide surveillance on suspicious Workers Comp claims. If the person is proved not to be disabled, usually by filming them engaging in physically demanding activities, his claim is disallowed and often he is prosecuted. Here is an example.
Repetitive Christmas Decoration Hanging Syndrome
by Jim Smith, Deputy Director of Investigations
"A female employee went out on a Workers Compensation claim due to the repetitive motion injury "carpal tunnel syndrome" in both wrists. She and her doctor indicated that she had a fairly severe case of carpal tunnel and could not use either arm or wrist for lifting, twisting or typing.
"Surveillance was approved, and initially we did not see any evidence contrary to the claimant's allegations. But rumors persisted in the workplace that the claimant was not as injured as she claimed.
"As the holiday season was approaching I suggested that we conduct surveillance near Christmas, thinking we might find the claimant involved in holiday activities inconsistent with her claimed injuries.
"We set up surveillance on a weekend early in December. We were quite amazed to see and film the claimant, over both weekend days, putting up outdoor Christmas lights and decorations outside the house. This included climbing a ladder and even getting up on the roof, untangling Christmas lights, lifting lights and decorations over her head, and using a staple gun to place the lights on the outside of the house. She did all this with no hesitation or obvious signs of discomfort or disability.
"We later learned that the claimant was separated from her husband and was the person responsible for all the 'chores' around the house. In this case, that included climbing up on the roof and preparing the house with all the signs of Christmas cheer.
"Once the film of this festive weekend was shown to the claimant's attorney, the holiday season became a lot less cheery for him and his client."
Another victory for truth, justice and lower insurance premiums.
About the Author: Tom Reitze is President of David Morse & Associates (http://www.davidmorse.com) , an independent investigations and claims adjusting company with 41 offices in 15 states.
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