Institute For The Future

What Your Facebook Profile Can Tell Fraud Investigators

 

An interesting story in the Los Angeles Times highlights the different ways that insurance companies have begun to monitor social networking cites in an effort to root out fraud. For example, a fraud investigator who sees a disability patient post photos of a recent distance run, might use the photo as evidence for further investigation--or to stop paying a disability claim entirely.

 

This sort of practice, according to the Times, is pretty common:

 

 

 

Social-networking sites have become such "standard tools" that Peter Foley, vice president of claims administration at American Insurance Assn., said that investigators could be considered negligent if they didn't conduct at least "a quick scan of social media to check for contradictions."

 

But the evidence gathered on these sites, Foley and other insurance experts caution, should be used only as a launch pad for further investigations and never as final proof of fraud.....

 

Mike Fitzgerald, a Celent senior analyst, said life insurance companies could find social media especially valuable for comparing what people will admit about lifestyle choices and medical histories in applications, and what they reveal online.

 

That could range from "liking" a cancer support group online to signs of high-risk behavior. "If someone claims they don't go sky diving often, but it clearly indicates on their online profile that they do it every weekend they can get away," Fitzgerald said, "that would raise a red flag for insurers."

 

 

 

 

I'm not sure I understand how liking a cancer support group is a sign of "high-risk behavior," but, as best I can tell, these sorts of searches have clearly become "standard tools." In just the past couple of months, for example, a separate investigation found that the Department of Homeland Security has begun using photos posted on Facebook to assess whether or not marriages have been faked for immigration purposes.

 

If this sounds familiar, it's the premise of an excellent, if disturbing forecast my colleagues in the Ten-Year Forecast put together a couple years ago about how all of our social media will lead to a "participatory panopticon." In effect, our desire to share details of our lives becomes its own form of surveillance.

 

One striking thing, at least in the context of health, however, is that most of us probably won't share the worst details of our health states with everyone we've ever met (in other words, our Facebook networks.) Or, as one expert quoted by the Times puts it, "No one puts pictures of themselves crying in a dark room, even if that's what they're doing 18 hours a day." But at least at the moment, investigators assume that a couple active photos or status updates imply that nothing is wrong.

 

Which makes me think that a person could apparently pull off insurance fraud by filing a claim, photoshopping some depressing photos, and posting them to Facebook. I say that somewhat tongue-in-cheek, but it strikes me that most of these investigations rely on a similarly shaky assumption: That our identities online are accurate and complete reflections of how we navigate the physical world.