IOD/ investigator question

[hannibal5]

Has anyone ever had their own town hire PI's to investigate them for an IOD?

A year ago last January I tore the crap out of my left shoulder at a structure fire in town. One of the guys lost control of a hand line while wide open, the nozzle came back took a ff's helmet that was next to me. Then the nozz hit the wall and hit the same guy in the back of the head. He was on his way down as I caught his full weight in my left arm.

During catching him and then getting him out of the building I ended up with 3 tears in my shoulder, 2 of them were full thickness tears. So far I have had 2 surgeries within 9 months of each other which included 3 pins and 2 anchors in the humorous due to a severed tendon in the shoulder.

My last surgery was in November. I was told that my day's of breaking down doors with a sledgehammer and pulling hose off the truck are more than likely over because I will most likely have a permanent damage in the shoulder.

And last week I found out that the Fire Dept ins company had hired 2 investigators to follow me around. They were not very good at following since they almost crashed into a school bus (got pic's of this one), caused an EA en route to the hospital to go on the wrong side of the road around a corner, drove on the wrong side of the road to keep a line of sight on me, and went flying past a day care center on a 1 lane road about 12 feet wide, going through stop signs and doing 30 mph in front stores at the mall to try to find me. I was in the far end of the lot watching to see if they killed a pedestrian. Not too mention that every time they followed me I was able to do a u turn and come up behind them.

They actually sat on the lot of neighbor and told them who they are and what they are doing. Needless to say I always got a call with vehicle plates and descriptions. They are from New Jersey.

I personally am quite disgusted with the fact that those who are supposed to protect their fire fighters would so easily throw them under the bus.

Has anyone else had this happen?

[johnny46]

I'm sure other people have had this happen. The fact is, some people fake injuries, firemen aren't saints, insurance isn't in the business of paying out and everyone has to cover their butts.

And sorry about the injury.

[GeorgeWendtCFI]

Couple of things;

1. They weren't from NJ. We are better than that.

2. THe town did not hire the surveillance team, the insurance company did.

3. WC fraud is one of the single largest sources of insurance fraud out there. The losses are measured in the BILLIONS of dollars.

4. If you are out of work for a legitimate injury that has caused you to become disabled, you have nothing to worry about. If you are trying to scam the system, you areprobably going to get caught.

[hannibal5]

Sorry George, but one of the registration's was ran through and it came back to a couple who live in NJ. The names they gave on Saturday night came back to the registration of their blue Ford Explorer. I will not for obvious reasons put their name on here. Futher investigation showed who they work for.


And yes I am legit, kind of tough to dis prove 2 surgeries.

[GeorgeWendtCFI]

Sorry George, but one of the registration's was ran through and it came back to a couple who live in NJ. The names they gave on Saturday night came back to the registration of their blue Ford Explorer. I will not for obvious reasons put their name on here. Futher investigation showed who they work for.


And yes I am legit, kind of tough to dis prove 2 surgeries.

Yo, tiger. Calm down.

The NJ comment was a joke.

Also, I never said you were not legit.

I would not take this so personnally. Many insurance cos. have automatic triggers for this type of investigation. They may also have gotten some kind of complaint from someone who doesn't like you.

The operatives are probably contractors who work for a company who is a vendor to the insurance company. If you feel that they jeopardized public safety while conducting their surveillance, you have every right to complain to the insurance co. and/or the State Ins. Department. It wouldn't hurt you to hold you insurance cos feet to the fire. But, be ready. They are not going to tell you anything about their investigation.

BTW, You're new. I am an investigator for an insurance co.

[mrpita]

What George said. My brother used to be a PI in FL and PA. No seedy divorce cases or cheating spouses, about 100% of his cases were insurance fraud, and it's all about the video. He'd sit in a target's neighbor's driveway for hours just on the hopes that some guy with a "back injury" would come out and lift something heavy, mow the lawn, or some other physical task, to disprove the nature/extent of injury. That 40 seconds of video of the guy carrying a bag of fertilizer/concrete/whatever from the car into the house, paid for days of surveillance. He used to tell me some of the tricks they used to ensure their subject was home, and to hide from detection; I guess his company was a lot more discrete than the one you got. I'd love to sugest ways of having fun with them, but the pragmatist in me thinks it better not to antagonize them.


Don't take it personal. They're (Ins. Co.) just trying to cover their posterior. I doubt that your fire dept. even knows/knew about the PI. Best of luck with your injury.

(BTW, if you do have permanent type shoulder damage, don't go having a catch in your front yard or anything to give them evidence...)

[ChiefKN]

Maybe their car was from NJ, but they sound like they might be from Pennsylvania.



Sorry about your injury. How was the other guy?

[johnny46]

Yo, tiger. Calm down.

BTW, You're new. I am an investigator for an insurance co.

He may be an insurance company stooge, but he's also a person.

You can take this guy, George. Whack him in the shoulder!

[GeorgeWendtCFI]

He may be an insurance company stooge, but he's also a person.

You can take this guy, George. Whack him in the shoulder!

Nah. I'm too old to fight. I'll just kick him in the nuts.

[GeorgeWendtCFI]

What George said. My brother used to be a PI in FL and PA. No seedy divorce cases or cheating spouses, about 100% of his cases were insurance fraud, and it's all about the video. He'd sit in a target's neighbor's driveway for hours just on the hopes that some guy with a "back injury" would come out and lift something heavy, mow the lawn, or some other physical task, to disprove the nature/extent of injury. That 40 seconds of video of the guy carrying a bag of fertilizer/concrete/whatever from the car into the house, paid for days of surveillance. He used to tell me some of the tricks they used to ensure their subject was home, and to hide from detection; I guess his company was a lot more discrete than the one you got. I'd love to sugest ways of having fun with them, but the pragmatist in me thinks it better not to antagonize them.


Don't take it personal. They're (Ins. Co.) just trying to cover their posterior. I doubt that your fire dept. even knows/knew about the PI. Best of luck with your injury.

(BTW, if you do have permanent type shoulder damage, don't go having a catch in your front yard or anything to give them evidence...)

It is not a CYA thing. Insurance cos. get whacked for BILLIONS of dollars in fraud each year. Mostly because many, many people (statistically, some of you here too) believe that it is not wrong to cheat the insurance company. they believe that they are entitled to it because they have paid the premium. WC fruad happens to be one of the biggest sources of this fraud. Really, the only way to catch someone committing this type of fraud (particularly when it involves an illness, psych component or soft tissue injury) is to catchthem in the act. With a video, there is usually no defense.

So, as I said, don't take it personally.

[hannibal5]

Maybe their car was from NJ, but they sound like they might be from Pennsylvania.



Sorry about your injury. How was the other guy?

All the other guy got was a concussion. He missed 4 days of work and was done. As much as I hate to say it, if I had to do it over again I would have still made the decision to try to catch him to keep him from splitting his head open on steel table (restaurant fire). I never thought twice about trying to catch a 250 lb FF w/ gear with 1 arm, I never thought I would have to defend myself for doing my job the way I was trained to.

[GeorgeWendtCFI]

All the other guy got was a concussion. He missed 4 days of work and was done. As much as I hate to say it, if I had to do it over again I would have still made the decision to try to catch him to keep him from splitting his head open on steel table (restaurant fire). I never thought twice about trying to catch a 250 lb FF w/ gear with 1 arm, I never thought I would have to defend myself for doing my job the way I was trained to.

Who do you have to defend yourself to? No one here questioned the legitimacy of your injury. If you have a legitimate injury, than you won't have to defend it to the insurance co. either.

[johnny46]

It may be frustrating, but they have to check on people. That's life.

[mrpita]

It is not a CYA thing. Insurance cos. get whacked for BILLIONS of dollars in fraud each year. Mostly because many, many people (statistically, some of you here too) believe that it is not wrong to cheat the insurance company. they believe that they are entitled to it because they have paid the premium. WC fruad happens to be one of the biggest sources of this fraud. Really, the only way to catch someone committing this type of fraud (particularly when it involves an illness, psych component or soft tissue injury) is to catchthem in the act. With a video, there is usually no defense.

So, as I said, don't take it personally.

George, what I meant by the Ins Co "covering themselves" is protecting against the fraud, I just stated it poorly. If they just paid out claims without worrying about fraud, they'd be fools - and out of business. You know better than I, but what do you estimate gets investigated this thoroughly - 10%, 1%, or maybe even just .1% of all claims?

I assume it's kinda like getting audited by IRS, there's some percentage where it's just dumb luck, but oftentimes there's also red flags that rankle someone at the Ins Co. to get the investigative ball rolling. Even though a particular case may through "harmless coincidence" have circumstances that meet those red flags. (In general, not talking about the OP's case here.)

[DeputyChiefGonzo]

If you are allowed to do some things... cover thy butt and GET IT IN WRITING from your physician and have it placed in your personnel file

I was out IOD for 20 duty tours with a back injury after a nasty fall. I had asked my physician about going out walking with the dogs when I started physical therapy. He gave me the okay, but I got it in writing "just in case".

The powers that be may still investigate you, but you will be covered.