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By Brian C. Jayne
Three weeks ago Joe Smyth submitted a theft claim for his 1990 Camaro and he is anxiously waiting for the check from his insurance carrier. Filing the police and claim report was a breeze. No one suspected that he was driving home drunk from a bar and missed a corner, but not a concrete barrier. His car suffered substantial body and suspension damage that he could not afford to fix. Nor could he report the accident since he had a previous DUI.
Instead of receiving a check, Joe received a telephone call from the insurance company asking for his assistance to help process his claim. Joe is about to be interviewed by a claims specialist. Whether the specialist is able to identify that this is a fraudulent claim will depend on proper interviewing techniques and the ability to recognize verbal behavior symptoms of deception.
One of the principles of proper telephone interviewing is to start the interview by eliciting an initial open response from the claimant. The claimant should be encouraged to offer a complete response to the initial open question without any interruptions by the investigator asking specific questions. As an example, the investigator may state the following, “Joe, so I have a complete understanding of this claim, could you tell me everything that happened concerning the theft of your vehicle?”
A truthful account will typically have three sections, (1) an introduction, which sets the stage for the claim, (2) the main event which, in this case, is the theft and (3) an epilogue that describes how the event has affected the claimant. In addition, truthful accounts often contain nonsequential recall, where the claimant’s mention of one incident stimulates recollection of an earlier incident which is included at that time (out of sequence) in the account. Finally, truthful accounts contain thoughts, ideas or emotional states as the claimant emotionally relives what happened. Here is Joe’s response to the interviewer’s initial open question:
Joe: “Well, there’s really not much to tell. I had this 1990 Camaro, and on Friday, October 6, I drove it to Brookfield Square at about 6:30 at night. Parked it in the parking lot and went into the mall to do some shopping. When I returned about 8:30, the car wasn’t where I parked it, so I figured someone probably took it.”
Interviewer: “Okay.”
Joe: “Well, I called the police and filed a report and that’s pretty much everything.”
There are a number of characteristics within an initial open response that are suggestive of an account that may not be entirely true. Deceptive claimants may spend a disproportionate period of time on the introduction or focus entirely on the event itself. A good indication of a deceptive account is one that does not include an epilogue. Not wanting to tell unnecessary lies, Joe did not include feigned emotional states or imaginary anger at the person who allegedly stole his car.
The deceptive account may also be identified because it is told in perfect chronological order. The claimant mentally rehearsed it chronologically, and because it is not based on factual recall, it is delivered chronologically. Finally, deceptive accounts may fail to include appropriate emotional states. Almost every truthful insurance claim involves a traumatic event and the investigator should expect to hear emotions, expressions or thoughts when the claimant recalls the incident.
Following the initial open question, the investigator should ask clarifying questions. These questions are designed to elicit further information within three areas:
1) Expand or elaborate about a particular area within the account, e.g., “Could you tell me more about your vehicle?”
2) Elicit explanations as to why something was, or was not done, e.g., “Why did you decide to go shopping that night?”
3) Elicit emotional responses, e.g., “What was your first reaction when you discovered that your vehicle was missing?”
Often clarification questions catch the deceptive claimant off guard because they delve into areas that have not been mentally rehearsed or anticipated. Responses to clarification questions may involve contradictory information or illogical behaviors, or the claimant may exhibit verbal behaviors which indicate probable deception. Let’s listen to Joe’s response to the third category of clarification questions.
Interviewer: “What was your first reaction when you discovered that your vehicle was missing?”
Joe: “What was my first reaction? Well, I saw that it was missing so I went back into the mall and called the police, you know, to report what happened.”
Interestingly, when asked about their initial reaction to a situation or event, deceptive claimants often relate physical reactions (calling the police) whereas truthful claimants are more likely to relate emotional reactions—e.g., “At first I thought I just forgot where I parked, so I walked up and down five or six aisles looking for my car. It just wasn’t there. That’s when I really got scared and realized that someone stole it. I just couldn’t believe that this was happening to me. I was beside myself and just stood in the parking lot in disbelief.”
Returning to Joe’s earlier response to the clarification question, he repeated part of the interviewer’s question (“What was my first reaction?”). A claimant who repeats the interviewer’s question before answering it is often buying time to formulate a response. A truthful claimant, on the other hand, knows exactly what the truth is and responds immediately without the use of any stalling tactic.
Following questions which clarify the claimant’s initial response, the investigator should ask direct questions. Direct questions elicit specific information that was not yet volunteered by the claimant. The following are a few direct questions asked during this telephone interview:
Investigator: “Joe, what was the condition of your vehicle before you reported it stolen?”
(1) Joe: “Even though it was a few years old, I would have to say that it was in good shape.”
Investigator: “Was the vehicle recently involved in any accidents?”
(2) Joe: “I haven’t been cited for an accident for more than twelve months.”
Investigator: “I realize that but sometimes a person may get involved in an accident and not report it to the police for a number of reasons. Did your car have any recent body or engine damage?”
(3) Joe: “Like I told the police, the car was in good shape.”
Investigator: “Why do you think someone decided to steal your car?”
(4) Joe: “Well, first of all, the parking lot is kind of an open place and I imagine it would be easy to do. Second, a Camaro probably has some street value to someone interested in it, and third, I didn’t lock my doors, which I should have, but that may have made it easy for this to happen.”
These four responses to direct questions each illustrate an example of deceptive behavior. Joe’s first response contains a phrase called a literal expression. Literal expressions represent the exact truth, if taken literally. Joe responded that he, “would have to say…” Of course he would have to say this because if he said otherwise (told the truth), his claim would be very suspicious. Other examples of literal expressions include, “My answer would be…”, “I can only state…”, or, “I can’t say what happened.” At the very least, when an investigator hears a literal expression, it should be realized that the claimant’s response involves speculation, e.g., “What time did you arrive at the mall?” “I would have to say sometime around 6:30, ah, 7:00 at the latest.”
The second response is an example of a specific denial. A specific denial is one which denies some narrow aspect of the question asked. In this example, the investigator’s question specifically addressed recent accidents the vehicle had been involved in, but Joe’s response referred only to receiving citations. By denying specifically, Joe merely implied that the vehicle had not been in any accidents.
Joe’s third response contains a deceptive strategy called “lying by referral.” Like most deceptive responses, if taken literally, the response represents the truth. When Joe stated, “As I told the police,” he is only telling the investigator what he told the police. While his response to the police was a lie, his response to the investigator is truthful because he is relating exactly what he told the police. Another common introduction that suggests lying by referral is, “As I indicated in my report…”
Joe’s fourth response represents a behavior called “listing.” When a claimant offers a list of possibilities (A, B and C or 1,2 and 3), the investigator should realize that the claimant has spent time mentally rehearsing his or her response to this question. A deceptive claimant is much more likely to mentally rehearse responses than one who is telling the truth.
Upon hearing Joe’s responses during the telephone interview, a qualified claims specialist should recognize that the claim is, at the very least, suspicious and arrange for a face-to-face meeting with Joe to further review his claim. It would be improper to confront Joe over the phone and challenge the validity of his claim. However, during a face-to-face meeting, the claims specialist can control the interview environment and is much more likely to elicit contradictory statements or even a confession.
A telephone interview serves as an efficient means to elicit preliminary information to assess the probably validity of a claim. For a number of reasons, telephone interviews should not be relied upon to solve suspicious claims through an interrogation conducted over the phone. To maintain open communications and future cooperation, the interview should be conducted in a non-accusatory manner and follow a four-step process:
1. Initial open question “Would you please tell me everything related to (claim)?”
a. Do not interrupt initial version of events.
b. Encourage claimant to continue with phrases such as “Okay” or “Alright.”
2. Clarification questions
a. Expand or elaborate on a portion of the response.
b. Elicit reasons why something was or was not done.
c. Elicit reactions or feelings relevant to the claim.
3. Direct questions
a. Elicit specific information not yet volunteered by the claimant.
b. Listen carefully for verbal symptoms of deception.
c. Ask follow-up questions when deception becomes probable.
4. Conclusions
a. Thank the claimant for his time and continue to process the claim.
b. Arrange for the claimant to submit an amended claim form or statement of events.
c. Arrange for the claimant to meet for a face to face interview or deposition.
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Brian Jayne is the director of research and development for John E. Reid and Associates, a firm that specializes in detection of deception services and training. Jayne has presented seminars on telephone interviewing techniques across the United States.
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