Defenders: Fraudulent medical claims caught on tape

Undercover video catches questionable medical claims plaintiffs

Author: April Molina, Investigative Reporter, amolina@ksat.com
Published On: Feb 07 2013 02:55:32 AM CST   Updated On: Feb 07 2013 03:42:14 AM CST
medical claims
SAN ANTONIO -

They are the two most common types of questionable claims filed in the state of Texas, and they're what keep private investigator, Dan Phillips in business; workers comp and auto accident injury claims.

Phillips described some questionable claims to the KSAT Defenders.

"He goes to his doctor's appointment, he's not to put his foot down and he knows and in the videotape you can see him, not putting his foot down he's using the crutches and then as soon as he gets his prescription filled a short time later, he's walking without crutches and he's doing just fine," Phillips said.

It is a waiting game, but one filled with serendipitous moments. Phillips remembers being on surveillance for a workers' comp case.

"All of a sudden the lady comes down the road, she's mowing a neighbor's yard and pulling weeds," Phillips said.

Phillips also shared undercover video he shot on an auto liability back injury case that made an impression on the jury.

"That guy had spent so many days with his cane and then that one day he let his guard down, put down his cane and took boxes of tile out of a pick up truck," Phillips said.  

Special agent for the National Insurance Crime Bureau, Michael Gallagher, confirmed everyone is paying the price because insurance companies are inundated with this type of fraud.  

In 2011, questionable bodily injury claims in Texas tallied 1,269. According to Gallagher, that number is higher than all the other questionable medical claims combined statewide.

For a list of recent stories April Molina has done, click here.