In many cases, files come in significantly over budget, leaving the adjuster to have to explain the overage to their principals, which is often a difficult sell, particularly if the claimant isn’t even observed.

This puts the adjuster in a compromising position with their client or manager and often results in having to shop for a new vendor.

Having been in the business of Investigations for over 35 years, I have occasionally heard complaints from claims adjusters regarding their current surveillance providers. These complaints usually involve a lack of results and/or improper use of the budget provided.Nino Calabrese

Adjusters and Defense Lawyers often rely on surveillance to help evaluate the merits of a personal injury claim and to establish the worth of the claimant’s injuries. Results are not always guaranteed, and there is always the possibility that the adjuster will be asked to invest in a surveillance report that will not help them further adjust the claim if the subject of the investigation is not seen.

Success is in the Details

Adjusters and surveillance firms can help increase their chances of success. First, it is important for the adjuster to provide the vendor with as much pertinent information about the claim as possible. This should include the claimant’s full name, address, previous address (if known), date of birth, driver’s licence number, the plate and description of the vehicle involved in the accident, home and cell number (if known), occupation of the claimant, claimant’s last known employer (if known), time and location of the accident, any available spousal information and family make up if possible, description of the claimant (if known), and list of alleged injuries.

Let’s start with the claimant’s full name, including middle name or initial. I have had at least one client ask me if this information is necessary. The answer, of course, is yes. Not only is the full name helpful with our pre-surveillance work up, so are any known nicknames for the claimant.

The claimant’s known address is obviously important, as are any prior addresses. There are certain searches investigators can do using an old address to find or confirm a current residential location. Often adjusters have this information, but do not necessarily understand the importance of passing it on to their vendor.

We are often told by adjusters that they do not have a date of birth for the claimant. This is especially true in Bodily Injury auto claims and slip and fall accidents. Often in the case of a Bodily Injury auto claim, there is an Accident Report in their file. It is helpful for them to pass these reports on to their investigator. These reports not only provide a date of birth (if the person was driving) or their age (if they were a passenger), but also often includes the claimant’s driver’s licence number if he or she was driving at the time of the accident. The vendor can run the driver’s licence number to retrieve or confirm the claimant’s home address and their registered vehicles. There are still some who do not know that the driver’s licence number also provides the claimant’s date of birth. For example, the last six digits in the driver’s licence number C0230-32207-90830 indicates that the licence holder was born in 1979, on August 30th, and that he is male. The digit 0 before the 8 is what identifies the driver as male. If the driver was a female born on August 30, 1979, their driver’s licence number would look like this: C0230-32207-95830. The number five before the eight indicates that the driver is female. If the female was born in a double-digit month like October, November or December, the 5 would be replaced by a 6. For example, a female born on October 30, 1979 would have their licence number end 7-96030 or 7-96130, if they were born on November 30, 1979.

The plate and description of the vehicle can also help. I have had many clients tell me that the claimant no longer has the vehicle that was involved in the accident. The licence plate number that was attached to that vehicle is still important for us to know as we can find out if it is now attached to another vehicle. Also, even if the vehicle is no longer plated, we often find it sitting in the driveway, helping us establish that the claimant continues to be associated with the address.

Any known telephone number for the claimant is also important. Adjusters often do not like sharing this information if the claimant is represented for fear that the investigator may use it to make direct contact with the claimant. However, investigators have the tools to determine to whom and where a number is listed which helps us develop or confirm a claimant’s home address. Not only does it help establish where a claimant may be residing, this information helps us with our open-source work that sometimes leads to the identification of self-employed business information, or events that they may be participating in, or services that they may be advertising for in places like Kijiji and using their home or cell number in the ad.

Knowing the claimant’s occupation and last known place of employment is also helpful. Understanding the type of work that they are or were involved in can help us determine a suitable start time for the surveillance to rule out that they have not returned to work. For example, a claimant who works in the construction business may require a 5:00 am start time to see if they get picked up and taken to a job site. Yet someone who has always worked in an office may require a later start time. Also, the last known employer’s address is another location that the investigator can drive by if the investigator loses sight of the subject in the area. I cannot tell you how many times we have found that claimants who are ‘unable’ to work, are then seen working at the very same place of employment. Of value as well, is the location of any treating facilities or medical doctors they may be seeing, or other locations that the investigator can check if visual contact with the claimant is lost during surveillance.

The time and location of an accident can help us determine a good start time. For example, someone who has an accident on Hwy 400 in and around Orillia late on a Friday night, may have been on his way to the casino in the area. Perhaps it may be worth trying a late-night surveillance on a Friday. I also found it useful to determine the date of slip and fall accidents at grocery stores. Many people are creatures of habit and often shop on the same day of the week. If the slip and fall happened on a Wednesday for example, it may help to initiate surveillance on this day to see if they go grocery shopping.

Surveillance is not an exact science and, at times, someone else in the household can be mistaken for the claimant by the investigator. If a description of the claimant is available, please share this information with your vendor. We have often heard after the fact that the client happened to have a photo of the claimant. Sometimes it is in the form of a driver’s licence card that the adjuster has in their file. Again, please send your investigator a copy of the picture at the time you send in the assignment. If you are aware of who else lives with the claimant, please share this information as well to help avoid misidentification.

Finally, the adjuster should provide the investigator with the claimant’s alleged injuries so that they can focus on them and have the report reflect those injuries. For example, if the claimant alleges to have restricted use of their left hand, there may not be any need to go into in-depth detail in the report about how they can turn their head from left to right. Understanding that the claimant may have a head injury, as an example, can help the investigator to be aware of how the claimant interacts with others or is able to complete simple transactions such as making a purchase at a store or depositing/withdrawing money at a bank.

The Importance of Pre-Surveillance Prep

Once the investigator is equipped with details of the claimant and their alleged injuries, they should never start the surveillance without independent confirmation of the information provided by the client. We are often given “stale” information that is no longer current. People move and don’t always let their adjuster know. This can result in days of surveillance spent on a property that the claimant no longer has any association with. A good investigator will always ensure that they have confirmed the claimant’s proper name, have the claimant’s current address, and know what vehicles they may have access to before they even begin surveillance. This means running family members for vehicles. Some investigators make the mistake of only searching for the claimant’s vehicle. In cases where they may be not be able to get close enough to see who leaves the house or the underground garage of a building, it is possible for that claimant to drive by the investigator in a spouse’s vehicle without the investigator realizing it.

The thirty minutes or so that the investigator spends on doing the pre-surveillance work-up, which many of us refer to as a “prep,” increases the chance of success and could save money by not conducting surveillance at an address the claimant no longer resides at. Using a variety of databases that we have access to, we can look up phone numbers, develop property ownership information, confirm access to current vehicles and much more. This also means determining a claimant’s social media presence, which may provide us with an ID picture, but can also give us leads into upcoming events that the claimant may be attend. Not to mention that a review of social media can often tell us a story of the claimant’s pre- and post-accident activities.

Once the “prep” is completed, we know a little more about who the claimant is, which can help us determine the best time to start a surveillance file. We can coordinate surveillance around a date that we may have determined that the claimant will be participating in an event. We can postpone surveillance and let the adjuster know if we determine that the claimant is on vacation and away from home. The “prep” also helps prevent us from doing surveillance on a residential location that the claimant is no longer associated with. The “prep” forms the foundation of the investigation and should never be skipped. 

Investigators often make the mistake of treating each assignment the same. It is important to analyze the results of the pre-surveillance work up along with taking into the account the subject’s age, employment history, claim details and then create a strategy. The client’s money is better spent if you consider all the information known about the subject and base a strategy around the surveillance accordingly.

Our job as investigators is to provide information to the file handler to help them make decisions on the claim.

Once the investigator has retrieved and/or confirmed the claimant’s home address; conducted a review of their online presence; checked all social media; and determined what vehicles the claimant may have access to, then they are ready to start surveillance. It is helpful to start the first day early enough to ensure that the claimant has not already left. A quick drive by the residence late at night helps locate the claimant’s known vehicles. If the vehicles have not moved by the next morning, there is a greater likelihood that the subject is still home.

Surveillance is much like fishing: best results are obtained by starting early and staying for the day. There is a thought that a client’s money is better spent by conducting short periods of surveillance and discontinuing if the subject is inactive. In my experience, this is a way to quickly use up the budget and have nothing to show for it. There are usually fees associated with travel time and kilometres, which the investigators incur each time they start and end the surveillance, which quickly eats up the budget. Also, by attending later in the day, it can be difficult to know whether the subject left before the investigator arrived. Again, the best results are always obtained by getting to the claimant residence early and staying for the day. An investigator who leaves the site after two or three hours has a greater chance of missing the subject leaving. A successful investigator is a patient one.

Investigators should never underestimate the value of walking by the claimant’s vehicle if it is on public property. The inside of the vehicle can sometimes tell us if the claimant has plans for the day by notes and documents left in plain view. Sometimes we see parking stickers on the windshield that may help us determine an employer or if the subject is a student. We can also see if there are any medical devices such as a cervical collar or back support in the vehicle. I recall one case where a “walk by” revealed a musical textbook. The book was on theory and the discovery led to an additional investigation, which revealed that the claimant was providing guitar lessons and was earning income that the adjuster was unaware of.

Claimants who reside in apartment buildings often present additional challenges. They can exit the building from several locations. An investigator may not be able to monitor them all. Also, if the investigator is sitting outside of the garage, waiting for the claimant’s vehicle to leave, they can miss them getting picked up by a taxi or a friend or by them exiting from another location. To increase the chance of success with an apartment building surveillance, it is important for the investigator to enter the building and discreetly monitor the claimant’s apartment door. Often investigators who attempt to wait outside for the subject to leave the building, not only miss them getting picked up or leaving from one of the other exits, but they also miss activities such as the claimant using the building’s laundry room or carrying loads of laundry to and from their apartment.

Buildings with their own laundry rooms often have bulletin boards where tenants can advertise services. A quick check of these boards has often provided useful information, including identifying claimants who provide babysitting or housekeeping services. I often tell my investigators that information doesn’t always come to them. They need to work the file and look for leads themselves.

Our job as investigators is to provide information to the file handler to help them make decisions on the claim. Decisions cannot be made if the investigator does not see the claimant. Both the client and the investigator can play a role in helping to increase the chances of success on surveillance. Adjusters should provide their investigator with as much pertinent information they have about the claimant. Investigators should always conduct a preliminary investigation to confirm that all information is current and to develop additional leads. Choosing the right time and date to initiate the surveillance, based on intelligence developed prior to starting the observations, will likely make the difference between a no result report and one that the adjuster can use to confidently adjust the claim.

Nino Calabrese is the Director of Investigations at Xpera Risk Mitigation and Investigation in Toronto. He can be reached at nino.calabrese@xpera.ca.

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Reproduced with permission from WP Magazine