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Message From The
President
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Ed Cotilla
President - Ethos Risk Services |
This is our last edition of the Examiner for this year. I can almost hear the collective groans and sighs out there. But don’t worry - we will be back with fresh perspectives and hopefully bright, helpful ideas in future quarterly installments of The Examiner in 2010.
It’s been a rough year for sure for many individuals and organizations across the country. Our country has experienced near financial collapses on Wall Street, an unprecedented number of mortgage foreclosures, and a weak economy that has fallen into recession. Unfortunately, in this environment, fraud, corruption, and risk-related events escalate, thereby creating increased liability and concern for businesses of all sizes. Studies have shown a clear increase in the number of questionable claims related to possible cases of insurance fraud during the past year as the economy continued its downward spiral. A definite increase in opportunistic fraud was identified as the struggling economy perhaps created a higher incentive or motive to commit fraudulent activities.
At Ethos, we continue to fight the good fight by developing new strategies and skills to help our clients combat fraud so they can remain secure and profitable. This past year we increased our service offerings in an effort to provide our clients with a one-stop risk mitigation solution. Understanding different skill sets are required, we created various divisions in our organization to handle insurance investigations, mortgage fraud investigations, SIU services, subrogation, corporate due diligence, pre-employment screening, and even Level II FBI background checks through our Live Scan fingerprinting service. We partnered with numerous clients to include insurance companies, third-party administrators, government entities, volunteer organizations, and corporations of all sizes. Our steadfast goal is to assist our clients in saving money by helping to identify/prevent fraud, use accurate information to make informed business decisions, and hire qualified, honest employees.
We are excited for the launch our new sleek website in the beginning of the New Year. We will roll out our new website in January 2010, along with some major enhancements to our client account management system. Our clients will have full access to our proprietary claims system, allowing them to enter assignments, review and enter case notes, view reports, watch streaming video clips, run various metric reports, and much, much more. Our updated system improves turnaround time, creates a paperless environment should our clients wish to operate in this manner, and streamlines the entire investigative process. Our motto at Ethos is to leave no stone unturned and to provide the most thorough investigative results in the industry. We are 100% committed to this philosophy and will never waver in our pursuit of exceeding our clients’ expectations.
I seem to say this every year but it’s truly hard to believe how fast this past year has flown by. Halloween has come and gone and before you know it the holiday season will be in full effect. Let me be one of the first to extend best wishes for a safe and joyful holiday season from our families to yours. I believe there is a true cause for optimism in 2010 and as Americans have done throughout our history we will pick ourselves up by the boot straps and surge ahead in a positive manner. Please sit back and take a few minutes out of your day to peruse this latest installment of the Examiner. I hope you find it enjoyable and perhaps learn a thing or two along the way.
Kind Regards,
Ed Cotilla
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Scam Alert: Knowing The Signs of Fraud
It’s no secret that fraudulent activity increases in a soft economy. While the vast majority of workers are honest, there are others who would rather have a free ride on our collective dime. When people abuse the system, we all pay through higher premiums. Consumers are feeling the squeeze and are increasingly on the lookout out for those who might be less than honest about alleged workplace injuries. Increasing awareness of the different types of scams and the motivations of those who commit them can only help to keep fraudulent claims under control.
The Coalition Against Insurance Fraud has compiled a Scam Alert, which educates consumers about the various types of insurance-related fraud. This simple guide also explains the costs of fraud to society, the consequences of getting caught and what signs to look for. It’s a great tool for anyone who is interested in fraud prevention and detection.
Best Catch
At Ethos, our highly skilled, experienced team of investigators consistently deliver superior results to our valued clients. In each edition of The Examiner, we recognize their outstanding efforts in our Best Catch feature.
This time, investigator Daniel Johnston earns honors for his work on a case in which the claimant maintained that he could not work due to an alleged work-related injury to his lower back. He was receiving sizable monthly checks to compensate him for his lost ability to earn wages.
Our client ordered three days of surveillance in order to document the claimant’s activities. On the first two days, the claimant was not overly active, but did leave the house to run some errands. On the third day, however, the claimant was observed as he spent hours driving through local neighborhoods sorting through rubbish for scrap metal, which he hauled in an attached trailer. At one point, the claimant was even seen lifting a refrigerator off of the ground and placing it in the trailer by himself! After filling the trailer to capacity, the claimant drove his haul to a local scrap yard and sold it. If his back was bothering him, he did a masterful job of hiding it.
While it’s not an every day occurrence to see a claimant lifting a refrigerator, our investigators have an excellent track of documenting claimants exceeding their stated restrictions.
Way to go, Daniel!
Ethos Busts Hollywood
In every issue of the Examiner, we take a tongue-in-cheek poke at the film entry in our lighthearted feature, Ethos Busts Hollywood. A major movie costs a lot of money to make. Between actors’ salaries, set designs and musical scores, the studios invest bundles to make sure their pictures come out just right. Most films have one person whose only job is to maintain continuity – that is, the consistency of the characteristics of persons, plot, objects, places and events seen by the reader or viewer. Sometimes, these folks do a fantastic job and there are very few continuity errors. Other times, well……not so much.
Read More
The Ethos Eight: Q & A with Investigator Beverly Carter
Welcome to this installment of The Ethos Eight, The Examiner’s Q & A section featuring our investigators. This time we're getting to know Beverly Carter, who started with Ethos recently, but has extensive investigative experience, including work with various governmental agencies.
Ethos Risk Services: Where did you grow up?
Beverly Carter: I grew up in Northern Kentucky in a small town called Erlanger. It is home of the Greater Cincinnati International Airport. So when your flight states you are flying into Cincinnati, Ohio......let's just say you aren't. Gotta love that one.
ERS: How long have you worked at Ethos Risk Services?
BC: I started at Ethos in early July 2009.
ERS: Why did you decide to become an investigator?
BC: I always wanted to live in Florida, so in 1997 I began a career in state government with the Florida Department of Revenue helping to prosecute parents for non-payment of child support. This involved lots of locate work, so my skip tracing knowledge I learned as a Training Manger for a national student loan collection services company in Ohio came in handy. I left the Department of Revenue for the Florida Office of Attorney General, met some interesting politicians and became a family law paralegal, again helping prosecute child support cases. After several years with the OAG, I took a position with the Pinellas County Sheriff's Office as a child protective investigator. So investigations appear to be my destiny.
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Did You Know?
Studies show that successfully returning injured workers to their jobs directly correlates to the length of time that they have been out of the workplace.
US Bureau of Labor and Statistics indicate that when an injured worker is out of work for 6 months, that there is only a 50% probability of them returning to work. If the injured worker is out for a year the probability of them returning to work drops down to 25%. If an injured worker is out more than 2 years, there is virtually no chance of having them return to work.
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