9 Investigates: False disability claims on the rise, according to officials

by: Blair Miller Updated:


CHARLOTTE, N.C. - State investigators said they’re seeing a spike in people who claim disability but in some cases are not disabled at all.

The fraud is adding up to millions of dollars.

State investigators said a video showed a clear case of someone trying to cheat the system and claim thousands of dollars in disability insurance.

The video shows a man and a woman walking out of a store in Asheville and as the white car starts to back up, the man heads right for it.

“Look how he starts to run,” said one investigator.

Investigators walked Channel 9 through the video where the man gets hit by the car, and the investigators said it was on purpose.

“See how his gait starts out really fast and then he sees his opportunity and then throws his hip into the vehicle,” the investigator said.
The man in the video did file a claim, which he dropped after investigators started asking questions. Investigators have a long list of other people claiming to be disabled when they’re not.
The investigator said one is Melissa Carter of Rowan County. State records show she was paid $54,000 in disability claims.
Carter, who lives in Salisbury, had been collecting the disability insurance money for years.  Investigators said, at first, she was entitled to the money because she truly was disabled.  But then, they say, they noticed something that didn't add up.
Investigators point to medical bills and doctor's notes that they say had been fabricated.
In one insurance claim, investigators said she simply changed the date on an old claim and resubmitted it.
The month number was originally a two, but investigators said it was changed to a four, creating a new disability payment for thousands of dollars.
Investigators said Carter collected $17,083 in false claims. After pleading guilty in court, she was ordered to pay it back.
Eyewitness News went to Carter’s home in Salisbury to ask questions, but no one answered the door.
Carter was one of 230 people arrested in 2013 for insurance fraud, a record number for North Carolina.
Last year in the state, insurance companies paid $840 million in disability claims. Of that, $120 million went to people who investigators said  filed false claims.
Chet Effler is a fraud investigator in Charlotte for North Carolina’s Department of Insurance. He said disability fraud cases in the area have skyrocketed.
“It’s absolutely coming back on the consumer,” Effler said. “Your premiums that you pay for insurance in this state are a direct correlation to the amount of loss that’s been paid.”
Investigators have gotten more aggressive with new technology that can quickly spot a fake claim.
Investigators said it’s hard to keep the upper hand because the cheaters are getting better too.
“With personal computers, people can alter dates, they can alter forms and they can submit those to the insurance company,” Effler said. “This is an epidemic for the industry to tackle.”
Investigators believe the economic fallout from 2008 and 2009 is the reason they're still seeing a rise in fraud cases.
Many of their investigations begin with people calling in tips. For more information, click here to for contact information about putting in tips.