SIU CORNER: Will the Real John Smith Please Stand Up?

Canal SIU-Corner GraphicSometimes the claim is just part of the story. In Canal’s Special Investigation Unit, we are always on the lookout for that proverbial red flag. Many motor vehicle accidents appear straightforward initially – someone is injured and requires medical treatment – but then we begin to check details and uncover a scam. John Smith is not always who he says he is.

Such is the case with medical identity theft, a growing trend we have recently detected in numerous client claims. The identity thief begins by actually purchasing fraudulent documents (Social Security Cards, passports, birth certificates) from ID theft brokers. Sometimes they use these documents to defraud government agencies, such as another state’s Department of Motor Vehicles, into issuing photo identification that uses the thief’s picture with another person’s name.

With this false identification in hand, the thief can receive medical treatment, prescriptions or even obtain surgeries, all in the name of the victim. In some cases, the thief is in a real accident, and may be genuinely injured, but other times, the thief actually stages an accident to begin the process. The accident is used to justify the desired medical treatment, either for themselves or for others who have also assumed the false name.

Canal is actively reviewing claims and has sophisticated software to assist in identifying this type of fraud. Investigating the details is key – something as small as mismatched addresses or inconsistent descriptions between records can unravel a thief’s plans. It is an important extra layer of protection, and we believe every claim deserves this scrutiny because things are not always as they seem.

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Screen Shot 2014-05-07 at 9.29.16 AMShould you suspect fraudulent activity, please contact Canal’s toll-free SIU HOTLINE AT 877.561.1599 OR EMAIL SIU@CANAL-INS.COM.

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