Catching Insurance Fraud in the Act

Craig Dye graduated with a Bachelor of Science in Criminal Justice in December 2011.
Craig Dye graduated with a Bachelor of Science in Criminal Justice in December 2011.

In his first case as an insurance fraud investigator, Craig Dye was assigned to the auto insurance claim of a Kentucky man with debilitating back and neck pain. On the third day of surveillance, the man pulled lumber and materials out of his truck and began a building project in a client’s yard.

“It was pretty cool catching him in the act of insurance fraud,” said Dye, a 2011 College of Criminal Justice graduate. “He pulled out tools and equipment and began working on saw horses with lumber. He was bending, stooping and kneeling with no problem.”

Filming a claimant who alleged neck and back doing a building project.
Filming a claimant who alleged neck and back pain.
Dye is an investigator with Claims Verification Inc., one of the largest independent investigation firms in the country, which works exclusively in the insurance industry. As a licensed private investigator, Dye is assigned to cases of suspected fraud in Tennessee and Kentucky, his hometown state before relocating to Houston in 2002.

“I really wasn’t interested in being a police officer; I wanted to look at something out of the box,” said Dye. “We are not so much in the criminal justice system as we are part of the justice system. We are dealing with suspected criminals committing mostly white collar crimes.”

Like a good detective, Dye is involved in many aspects of the investigation process, such as performing background checks, doing surveillance, taking statements, canvassing for witnesses, documenting accident scenes, or scouring through court documents. To capture incriminating evidence, Dye has a Sony Handycam and a small spy camera at the ready.

Documenting a house fire, a suspected arson.
Documenting a house fire, a suspected arson.
Most of his work entails surveillance, following claimants to document whether insurance collections for injury or disease are justified. Armed with a “face sheet,” which contains whatever pertinent information the insurance company can provide, Dye’s mission is to track the person through their daily routine. While it may sound easy, following someone undetected through the windy, hilly back roads of Kentucky is often very difficult.

“These are pretty rural country roads,” said Dye. “They are really windy and hilly. I try to do my best to stay on them, without them knowing that I’m there. It gets pretty hard after 20 miles on the same road.”
As part of the investigation, Dye also will take statements from claimants and witnesses, such as those who see a slip and fall case in a store. They may canvass an area for witnesses to an accident.

Dye also may be called upon to document an accident scene, which may include an automobile or factory accident. He will note key features of a scene in his report, such as lighting, weather, and any broken equipment.

Dye is sometimes called by insurance companies to locate claimants or witness. He often uses Accurint to do background checks or surfs social media on the Intent to find individuals.

Dye said he enjoys his new-found career because every day is different.

Measuring skids marks in a fatal accident.
Measuring skid marks in a fatal accident.
“Even though 70 percent of my job is surveillance, there is a lot of variety,” said Dye. “You can be taking statements, documenting an accident scene or going to court looking for records. The company also does not micromanage us. We make our own schedules.”

After starting in retail loss prevention and as a security officer, Dye said he found his niche at the 2011 Criminal Justice Career Fair at Sam Houston State University, an annual event that attracts dozens of employers from law enforcement, corrections, victims services, forensic science and security firms. There he got his first introduction to insurance fraud investigation with PhotoFax and researched many firms that offer these specialties, including GlobalOptions, HUB Enterprises, Veracity Research Company, and Advantage Surveillance.

“This is my first real job,” said Dye. “Most people aren’t going to find their dream job right away, so I would suggest they do some hourly security work first. It gets your foot in the door for doing surveillance.”

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