Insurance Fraud

UNCOVERING FRAUD…

GRAND DELIVERS SOLUTIONS
THAT DEMONSTRATE MUTUAL VALUE

Fact… The insurance industry, one of the largest and interdependent U.S. industries, consists of more than 5,000 companies with over $1.8 trillion in assets. It is broken down into two segments of equal importance: property/casualty and life/health.

Fact… Insurance fraud, whether external or internal (within the insurance company itself), has become one of the most prevalent and costly white-collar crimes costing carriers $85 to $120 billion annually.

Like any business, insurance companies must protect against fraud and similar abuses. Yet, they are most vulnerable and are confronted every day with everything from slightly exaggerated claims to corporate organized deception. GRAND assists insurance carriers and works with their adjusters, examiners, and legal representatives - as well as Claims Department Special Investigative Units (SIUs) and third party administrators (TPAs) - to detect, investigate, and reduce exposure to all types of insurance crimes committed by individuals and or organized groups who attempt to defraud through a myriad of sophisticated fraudulent schemes.

Challenge: Today's insurance environment is wracked with challenges.  For example, many carriers have been forced to downsize their claims staff in order to contain costs as the result of fraud abuse.  At the same time, more and more insurance policies are being sold to accommodate a growing population’s needs... and the elderly population numbers are increasing as is the associated need for healthcare. The end result - more claims.  Add to the mix, a global economy where corporate white collar crime and electronic crime (faceless white collar crime) are on the upswing... and the fact that law enforcement cannot keep pace to adequately handle these illegal corporate activities. 

Solution: In this environment, GRAND acts to assist clients with comprehensive solutions that are diverse in terms of both services and people.  This diversity combined with technology and technique practices, delivers remedies that are cost-effective, secure and reliable.  We create value for clients and can help improve their profitability in tough environments.

What we do...

... Investigate claims in which there is suspected fraudulent or criminal activity, such as arson,
    workers' disability, staged accidents, or unnecessary medical treatments.

... Investigate cases ranging from simply overstating damage to a vehicle, to complicated fraud
    rings support by dishonest professionals (doctors, lawyers or even insurance employees).

... Conduct background searches.

... Take statements and interview the policyholder and other parties entitled to compensation or
    benefits - as well as witnesses to the occurrence of the insured event.

... Perform inspections and reconstruction of the scene, accident, or occurrence of insured event.

... Gather information by factual investigation(s).

... Collect and compile data in an unbiased and objective manner.

... Perform 24/7 surveillance services - including video and still photographs.

... Work effectively with insurance companies to negotiate settlements.

Outcome... GRAND often provides evidence that reveals  no damage, loss or injury
has occurred - enabling insurers to deny claims without further delay and or cost.

GRAND services…

Property & Casualty Insurance

  • Theft, burglary & fire loss investigations & assessment
  • Financial & background investigations
  • Motivational factor investigations
  • Liability investigations (including Maritime)
  • Worker’s Compensation investigations
  • Claimant profile search
  • Surveillance
  • Previous claim history
  • Scene investigations
  • Witness locates, interviews & statements

Life & Health Insurance

  • Accidental death investigations
  • Contestable death claims
  • Disability investigations
  • Contestable disability claims
  • Fraudulent claims
  • Surveillance
  • Claimant profiling
  • Medical history
  • Financial searches
  • Eligibility review
  • Claimant interviews & statement

Business Related

  • White collar crime investigations
  • Material damage assessments
  • Asset searches
  • Cyber crime investigations
  • Business interruption analysis
  • Product recall/liability
  • Professional indemnity
  • Intellectual property matters
  • Catastrophe/disasters

Accident Related

  • Fraud investigations
  • Surveillance – 24/7 physical (stationary & moving) & electronic
  • Video, audio & still photography
  • Claim history
  • Background searches
  • Prior claims
  • Claimant/witness interviews and statements
  • Locates
  • Chronological reporting of events

Litigation Support –Trial Preparation

  • Investigations across all insurance lines
  • Forensic investigations
  • Video, audio, & photography evidence
  • Electronic & paper evidence
  • Surveillance
  • Scene reconstruction
  • Claim history
  • Chain of custody protection
  • Review of all related reports
  • Court standard, single source reporting
  • Trial visuals, graphs, charts
  • Expert witness testimony
  • Security & protection

 

For related services, see Services Directory.

 

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On this website, the terms "Grand" "the company," "we," "us" or "our" refer to Grand Investigative Services Corporation d/b/a Grand ISS and/or its subsidiaries or affiliates. The Investigative, Security, Forensic and or related Technology programs described on this website are owned and/or operated by subsidiaries and affiliates or subcontracted services of Grand ISS.