I-Spy: How Social networking is impacting claims investigations

Sedgwick © 2013 Confidential – Do not disclose or distribute.
I-Spy:
How Social Networking
is impacting claims
investigations

Sedgwick © 2013 Confidential – Do not disclose or distribute.
VINCENT P. VOSSEL FCLA
Manager Client Services, SIU
Sedgwick Claims Management Services, Inc

Sedgwick © 2013 Confidential – Do not disclose or distribute. 3
I-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

• History of SIU and use of social networking
Traditional SIU
• Investigate identified potential
fraud
• Claim cost savings
• Reactive approach
• Dependent on the examiner to
reach out
The New SIU
• Creative new approaches to
identifying fraud
• Investigation worked from a
desk before any field
• Claim expense reduced
• Calculated approaches
• Earlier detection – more cost
savings
• Timely return on results and
updates electronically

 1995 – General public obtains access to the internet
 AOL, CompuServe and Prodigy begin dial-up service (14.4), Amazon launched, Bill
Gates 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

• 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 and
targeted.
• Social Revolution

 More than 20 million hours of video were
uploaded during 2011 and over 48 hours of video
are uploaded every minute.
 Over 3 Billion views per day
 More video was uploaded to YouTube in 60 days
than the three major networks created in 60 years.
 70% of YouTube traffic comes from outside the US.
 YouTube reached over 800 Billion playbacks in
2011

I-Spy, Social Networking

• Social Network Technologies
 Photo Sharing
 Email
 Blogging
 Video
 Micro blogging
 Topical Chat Pages
 Instant Messaging
 Texting

• 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

What’s Hot

What’s Not

Social Networking Pages
 A typical social network page contains over 30 pieces of personal
information 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

Photo Sharing
Photo Sharing Sites
 Flickr
 Photobucket
 imageView
 Smugmug
 Shutterfly
 Postimage
 Webshots
 Imgur
Photo Sharing Websites for Twitter users
Instagram
 Flickr
 Mobypicture
 Tvider
 Twixtr
 Ow.ly
Twitpic
 Yfrog

Geotagging
• Geotagging is the process of adding geographical identification
metadata to various media such as photos, video, websites, text
messages or RSS feeds and is a form of geospatial metadata.
 This data usually consists of latitude and longitude coordinates, though they
can also include bearing, distance, accuracy data and location names. This is
most commonly used with Photographs.
 GPS enabled smart phones and
digital cameras will geotag photos
when taken through those devices.
(EXIF image file)

Metadata
• Metadata is data about data. descriptive statistical information about
the elements of a set of data. This hidden data is used by computer
programs and sites to accurately process information. i.e. How is it
encoded, software.

“Checkin” posting sites (Foursquare and Gowalla)
 These are mobile applications for users to connect with “friends” and
update their location by “posting” or “checking in.”
 Users must register at the sites. These sites record the users activities
and 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

What is the value in Checking these sites?
 Multitudes of information can be gathered on specific subjects and
their activities.
 Social media “Ego Trip“. People love to promote themselves these
days.
 # 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

The 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

Pre-Surveillance address check
• Residence address provided by Claimant:
15275 COLLIER BLVD, APT #201
NAPLES, FL 34119

Social Media results and insurance investigations
Verifying policy application information
Verifying facts of reported loss
Alibi for the claimant or insured
Checking claimants activity to verify disability
status
Locating a claimant for surveillance or
interview
Indentifying witnesses

Case Study: SNS Success Rate
Success 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%)

The Source
Social Network Engines
 Snitch.name
 Googleblogs
 Kgbpeople
 Whostalkin
People Finders
 Peekyou
 Pipl
 Spokeo
 Webmii
 Zabasearch
Ebay/craigslist Searches
 Ebay advanced search
 Searchtempest.com
Databases
 LexisNexis
 ISO
 APEX
 TLO
Public Records
 Publicrecords.com
 Accurint
 Real Search
 State sites
Business/Assets
 Dunn and Bradstreet
 IRB
 State DMV
 Property.com
 LexisNexis
Relationships
 State Fraud Bureaus
 Attorney Generals office
 NICB
 CAIF
 States Attorney
Districts Attorney

Why pay for searches when it is online and free?
What sites to search
Understanding laws and site policies
Monitoring on a regular basis –Searches
Capturing evidence

Proper 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

Privacy Terms of Service
• An estimated 77% of SN users don’t read their sites’ privacy policies.
Consequently, many are unaware that much of their posted
information is public.
 SN sites make it clear that information posted to them may be shared with others or
made available to search engines.
 End-User License Agreement (EULA) is a legal contract between the
manufacturer/author and end user of an application/software. Some of the content
you share and the actions you take will show up on your friends’ home pages and
other pages they visit.
 Even after you remove information from your profile or delete your account, copies of
that information may remain viewable elsewhere to the extent it has been shared with
others, it was otherwise distributed pursuant to your privacy settings, or it was copied
or 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 be
removed, such as messages.

Legal 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 a
successful claim handling or legal proceeding.

Fraud Conviction

Fraud Charges

YouTube video triggers fraud charges

Case Example
• Injury: PTSD as a result of
seeing a crane tip over and kill
the occupant.
• He is unable to work due to
his emotional state of mind
and not being able to focus.
• Date of Loss: 8-16-2007

Surveillance results

Sedgwick - 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 be
active on weekends.

Sedgwick – SIU
Our FAST results showed the following
activity:
1He plays for the Stallions of Country Club
Hills
http://www.stallionfootball.net/League
info www.gmfleague.comClaimant is
listed as #48Last game was 7/28,The next
game is 8/4 at 4410 W. 175th St.,
Country Club Hills, IL

Sedgwick – SIU
Social Network review:

Sedgwick – SIU
Social Network results:

Sedgwick - SIU
Our investigative results:

Sedgwick - SIU
Our Surveillance results:

Sedgwick – SIU
Injury:
Carpal Tunnel
Description:
“I can not grip my hands
without constant pain shooting
through my arms…”
Date of Loss:
2-10-2011

Sedgwick – SIU
Online search results showed he recently purchased a
bed and breakfast in Michigan. He was hosting visitors
and available for snowmobile tours and repairs onsite.

Sedgwick - SIU
We decided to take guided tour with the claimant as
offered:

Sedgwick - SIU
We spent three days touring the countryside:

I-Spy: How Social networking is impacting claims investigations

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