Technology is creating potential new scam sorties — and anti-fraud defenses. Mobile phones and wearables offer hints of things to come.
Mobile phones. The devices may be the newest emerging battleground in combating widespread heisting of people’s medical identities. Two recent reports provide telling evidence.
More than 25 million people will have their medical and/or personal info stolen from their health providers between now and 2019, says a new report by Accenture. That’s one of every 13 patients.
Mobile transactions form the newest arena for ID theft in general.
Some 8 percent of organizations report rising mobile scamming this year, up from 3 percent last year. Spoofing, account takeovers and device cloning are favored tactics.
It takes only a small leap to see how mobile hacking and security could become a growing fraud problem for the healthcare industry and their patients.
Mobile transactions are rapidly becoming prime portals for healthcare transactions. Googling “health care mobile devices” earns 46 million hits.
HHS also warns healthcare plans about a double mobile security concern: the digital highway of healthcare records and record sharing — plus growing migration of everyday transactions to mobile devices.
Wearables. AIG is investing in wearables to help stem bogus workers-comp claims and better understand comp losses overall.
A trackable device is embedded in workers’ vests. It monitors employee movements around factories, construction sites and other high-risk workplaces. Sensors transmit data in real time. Managers can better track workers wherever they go on-site.
Other comp insurers and Marsh & McLennan are interested as well, news reports say. Marsh endorses wearables for cutting costs, news reports say. Human Condition Safety has a wearables pilot underway at Citi Field in New York to simulate construction sites and large venues.
Facebook tries to block access in disability fraud case
A long-granted freedom to scour social-media accounts for fraud clues is being scrutinized by New York’s highest court.
The state Supreme Court will review Facebook’s attempt to block prosecutors from accessing nearly 400 accounts in a large disability-fraud case.
The Manhattan DA wants to access the accounts as part of his investigation into disability scamming by police officers, firefighters and other public employees. Many suspects have posted photos and videos that could challenge their disability claims, the DA says.
The requests are overly broad and violate the federal Stored Communications Act, Facebook retorts.
The social-media platform has no standing to challenge the DA’s search warrants, a mid-level court ruled earlier this year. [Matter of 381 Search Warrants Directed to Facebook v. New York County District Attorney's Office, 2015-1139]
Arson: spousal privilege. In a separate New York decision, spousal privilege didn’t apply when suspected insurance arsonist Travis Howard made incriminating statements threatening his wife, a state appeals court has ruled.
Howard tried to invoke spousal privilege to keep statements he made with his wife out of evidence. Howard made criminal threats against her. [People vs. Travis Howard, 105670, Appellate Division, Third Department, Dec. 15, 2015]
Workers comp: evidence. Firefighter Jeremy DeRosa paid a high price for being innocent. The Palm Beach, Fla. man twisted his ankle when he caught his boot in a crack between tiles of the firehouse kitchen.
A supervisor took DeRosa to a walk-in clinic. DeRosa kept complaining of pain after two shifts on light duty, clipping out newspaper articles. An orthopedist placed him on leave, and he was given an air cast. DeRosa collected full pay while on workers comp. He had too much pain even for light duty, he said.
Yet DeRosa was filmed walking around in sandals, without the cast. He was fired, charged with fraud, incurred $40,000 in legal fees, and lost his reputation and career. He also had to move into his parents’ home and take a job delivering flowers. No department would hire him as a fire fighter while his case was pending.
There isn’t enough evidence for DeRosa to face jury trial, the Palm Beach circuit court ruled. [Anthony Thomas DeRosa v. State of Florida, Appellate Division (Criminal), Case No. 2015AP9002AXXXMB]
Noisy messages blast fraudsters in Pa. outreach campaign
Getting noticed is a tough job in a world awash with information. Convincing people that insurance fraud is a dead-end street is especially challenging.
One state agency is ramping up anti-fraud messages to ear-splitting levels. The quiet, lowkey umbrella name: “Idiots, Liars and Losers.”
So goes an outreach campaign by the Pennsylvania Insurance Fraud Prevention Authority. It’s a principled stand against auto schemers. And a shout-out designed to rise above the din of messages competing for consumer attention.
IFPA is using verbal blunt-force trauma to shame scammers — and insurance fraud. It’s verbal brimstone, laced with dollops of humor. Flame on.
“Seriously dumb ... Amazingly idiotic” are just two headlines of TV and radio spots barreling at consumers in key locales. The multi-media effort highlights true-life fraud cases making news around the state.
One video spot is called “Clueless in Clearfield.” It recounts a man who lied to his insurer that someone carjacked his pricey Jaguar. He stored the car in a shed and sought a payout until someone overheard the guy bragging, and turned him in.
TV spots are airing in the Philadelphia area. Digital spots ran at an auto show. Radio spots will air on every other Philadelphia Phillies and Pittsburgh Pirates game and video spots will run on the Jumbotrons at every Philadelphia Phillies and Pittsburgh Pirates home games this season. Auto, homeowner and workers comp messages will air at the games.
Don’t be a But. A fraud-prone cartoon weasel named Weasy is another IFPA campaign. The edgy effort is themed “Don’t Be a But” and aims at youthful drivers. Some 45 percent of suspects arrested for auto-insurance fraud in Pennsylvania are 18-34 years of age, IFPA says.
Weasy does dumb things like trying to dump his car in a lake to fake a theft. He keeps being thwarted — a warning to young drivers. Drivers also can see the messages on standard and digital billboards in the Harrisburg area. It’s part of a test campaign that may expand to Philadelphia if it works out.
Cleverly, IFPA is playing Weasy videos on baggage carousels at the Harrisburg airport. And a short video will play at Harrisburg Senators AA-level minor-league games whenever a Senators pitcher notches a strikeout this season. The announcer will say “Don’t Be a But. Strike out insurance fraud in Pennsylvania!”
Medical providers must harden against cyber medical ID thefts
One of every 13 healthcare patients will have personal info stolen by cyber thieves by 2020, says a recent study by Accenture.
That’s more than 25 million people. Of these patients, six million will have their health records stolen by medical ID thieves and four million victims will pay related out-of-pocket costs.
Health providers pay as well. And it’s a high price for complacency in hardening against breaches.
• Nearly half of patients say they’ll switch medical providers if they learn their health records were hacked;
• Hacked health providers could lose $305 billion in lower lifetime patient revenues due to switching; and
• Each hacked provider lost an average of $113 million of lower lifetime revenue for every data breach it suffered in 2014.
The environment is ripe for breaches with talented hackers finding large gaps in provider defenses. Nearly 1.6 million people’s medical IDs were heisted in 2014, says the U.S. Department of Health and Human Services.
Fed up or fearful, many patients will defect to other healthcare providers they believe are better defended against cyber attacks.
“What most healthcare providers don’t recognize is that as a result of cyber attacks on medical information, many patients will suffer personal financial loss,” Accenture notes. “In contrast to credit card identity theft, where the card provider generally has a legal responsibility for account holders’ losses above $50, victims of medical identity theft often have no automatic right to recover their losses.”
Health providers should make cyber-defending a higher priority, including responding faster to breaches. More-active defenses can improve security 53 percent over two years, Accenture says.
About the author: Jim Quiggle is director of communications for the Coalition Against Insurance Fraud