Our Services

Insurance Fraud

Insurance Fraud is the driving force behind increases in health, life, and motor vehicle insurance costs nationwide. L.H. Investigations and General Consultant specializes in video-surveillance and can document whether or not the claimant is legitimately injured. The Agency’s Director, L.H. Vargas , personally Directs and Supervises every investigation regarding possible insurance fraud. We provide all clients with a comprehensive, court-worthy report and DVD and/or video at the conclusion of each investigation, besides maintaining a 24/7 open line of communication , updates and a daily summery of the investigative efforts with the Client.

The most common services L.H. Investigations and General Consultant provides for insurance companies and their attorneys are:

• Independent Medical Examination (IME)
• S.I.U./Fraud Investigation
• Surveillance
• Recorded and Written Statements
• Activity Checks/ In-Field Activity Checks
• Background checks
• Criminal history checks
• Witness locations
• Subpoena services
• Alive-and-well checks
• Neighbor interviews

Below please find some general information about the different insurance related cases:

Workers' Compensation

Workers’ Compensation abuse is one of the most common problems facing insurance companies. Thousands of individuals abuse these benefits every year.
We investigate claims to determine if an employee has faked or exaggerated their injuries.
Locate unreported income or employment at a second job, and attempt to find multiple claims under multiple identities.

Disability Benefits

Assist in determining claimant's current activities of any full or part-time employment held since the date of loss, dependents, health status, civil or criminal litigations, and activities in or around the home.
It is illegal to receive these benefits if you are not disabled, and can perform the functions of your job.
To do so is considered theft!

Automobile Accidents

It is illegal to receive treatment for phony injuries.
It is illegal for doctors, medical facilities, chiropractors, etc. to over bill for treatments.
It is illegal for people to stage car accidents to bilk or cheat insurance companies.
These are all violations of the Health Care Claims Fraud Act!

Health Care Claims Fraud

It is illegal to submit a false claim form to an insurance company in order to be paid for health care services that were not received or provided.

In addition, below please find some general information regarding insurance claims Red Flags.

Auto Accidents

There was a delayed reporting to the police of the accident’s occurrence.
All injured parties claim to have the same bodily injury.
The injured parties claim to have severe bodily injuries, but there has been very little property damage.
The injured parties all submit receipts for treatment from the same doctors.
The receipts for treatment are not originals, or they are illegible.
Continual reporting of identical medical treatments, despite the occurrence of accidents that took place at different times and places.
The car involved in the accident is old and not insured by obligatory insurance.

Loss of Income

The business employing the person who filed the claim is unfamiliar. There is no street address, but instead a postal office box address.
The submitted phone number of the business only records voicemail.
The income report is presented on paper with no letterhead or logo.
The person who filed the claim began work at the alleged business only a short time before the accident.
Inconsistencies between the seniority, time away from work and level of income reported by the person making the claim and his or her residential area and assets.
The person filing the claim receives guaranteed income from social security.
The person filing the claim has an especially high standard of living.

Businesses set on Fire

The building foundation of the business is unstable and possesses defective engineering with expensive rates of repair.
The business is located in an area known for crime with very little clientele and is difficult to get to.
Signs that reveal that valuable items were removed from the place of business prior to the fire.
The fire took place on a weekend or vacation day when no employees were present.
The fire detector system failed despite the fact that during its last test it was found to be in order.
The fire occurred right before the purchase of the business by new owners.
The whereabouts of family members or pets of the business owner during the time of the fire where unknown.
Testimonials claim that property was removed from the business right before the fire.
There is a familial conflict regarding the property.
There is a continual business conflict between the business partners.
The business owner tried to sell his business right before the fire.
The business’s inventory has expired.

During Submission of an Insurance Proposal

The reported residential address of the candidate is incorrect.
The candidate submits a postal office box number instead of a full residential address.
The candidate paid the premium immediately and in cash.
The candidate only submitted a mobile phone number.
It is not possible to meet the candidate in person.
The insured does not answer the insurance provider’s questions correctly or fully.

Auto/Property Damages

An enthusiastic witness volunteers to assist the person making the claim.
Claims of heavy damages to the property, with only marginal bodily harm.
Lack of a towing report in cases of heavy auto damage.
The involvement of vehicles purchased through a rental or leasing company.
The auto damage is repaired in a garage far away from the residence or place of work of the person who filed the claim.
All the vehicles involved in the incident were repaired in the same garage.
Delays prevent the examination by an appraiser.
The insurance was purchases only a short time before the reported accident.
The scope of the insurance policy was altered only a short time before the accident.

Apartment and Business Property Damage

The insured is in the middle of divorce proceedings.
Unlikely absence of the insured person from the region where damage occurred.
The insured person emphasizes the value of the damage and reports that cash was stolen.
The insured actively attempted to sell the damaged property just before the incident.
The damaged items are no longer in style.
The business owner was carrying “dead inventory.”
The damaged items are either forbidden or permitted for use in a limited manner according to the law.
The place of business in which damage was reported suffers from difficulty in fluidity, credit problems, and order cancellations.

Large and significant frauds may expose insurance companies to risks that can damage their stability and credibility in the eyes of the insured public. We believe that insurance companies are preparing themselves to deal with the fraud phenomenon. Our times demand the improvement of tools and means that can combat “insurance criminals.” And better sooner than later.

It is determined that 5% to 15% of all claims are fraudulent. This does not include claims that are exaggerated.

The average Workers Compensation claim alone accounts for $6,000 to $63,000 in benefits, medical, and administration costs. The indirect cost to the employer for productivity loss, overtime, rehiring & retraining of replacement staff can be 3 to 5 times greater than costs to the insurer.

L.H. Investigations and General Consultant is well aware of the fact that every case can be unique, for this reason, we have developed a process to maximize results in fighting insurance fraud cases. Our process ensures we maximize your case results, while providing the most efficient investigation: