A fraud perpetrator who falsifies records regarding a stolen car or jewelry is usually easy to identify, but fraudulent activities involving an individual's health are often much more difficult to determine.
Malingering is a type of fraud that is difficult to spot, and difficult to confront. When an individual continues to collect insurance payments by faking the continuation of sickness or injury, that is malingering.
Doctors are often uncomfortable about confronting individuals with the possibility that they may be pretending they are hurt in order to collect money fraudulently. The fraud perpetrators capitalize on the fact that, with some types of injuries, it is almost impossible for the doctor to know for sure that the patient is not in pain or disabled.
Some classic cases of malingering include:
Offense: A person whose car was hit from behind claims to have whiplash, or soft tissue injury to the neck. Such injuries are hard to disprove, as they do not show up well on x-rays.
Detection: A diligent investigator may take photographs or shoot video showing that the individual does not wear the neck brace and is very active physically when nobody is around.
Offense: A person steps in front of or into the side of a car, attempting to sustain minor injuries and file suit for a great deal of money. This may occur several times over a period of years.
Detection: An investigator or medical professional, acting on a hunch, may check on the individual’s past history of accident involvement and establish a pattern of suspicious minor collisions with vehicles.
Offense: A person may claim to have fallen or otherwise sustained neck, back or other hard-to-disprove injuries on the job.
Detection: If the person’s convalescence from an injury on the job takes longer than it should, an investigation may yield surprising results. In one Louisiana case, the person on disability leave was discovered working at the same occupation just blocks away from the site of the first job.