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NORTHERN REPORTING SERVICE, INC

 

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Below is a sample Surveillance Report.

Included are real video stills, and a demonstration customer login account with a sample video surveillance footage that accompanies this report.

NRS
NORTHERN REPORTING SERVICE, INC.


MINNEAPOLIS
4124 Quebec Ave. N, #301
Minneapolis, MN 55427
763-533-2006
800-582-2218
FAX 763-533-2087
nrs@nrsgetsresults.com
MINNEAPOLIS –MILWAUKEE- MADISON – DULUTH-WAUSAU


NOTE: Names and specific information in this report are fictitious.

May 5, 2005

CLAIMANT, JOHN Q   Claim/File: 201201201201
122 Anywhere Street   Requestor: John Smith
Sioux Falls, SD 57100   Co. Name: Insurance Co USA
     
Date of Birth: 01/01/05 Social Security #: 444-55-6666 Telephone: 555-555-1212

BACKGROUND: Workers-compensation claim: right shoulder and lumbar injuries.
  Date of claim: 01/01/05
   
ASSIGNMENT: Conduct three days of surveillance to monitor the claimant's activities.

SUMMARY

John Q. Claimant resides with his wife and son in Sioux Falls, South Dakota. During the surveillance we followed the claimant to a residence in Worthington, MN. The claimant worked strenuously pulling out fence posts with his hands there. We later observed and filmed him as he picked up furniture at a local furniture warehouse in Sioux Falls, SD. The claimant also went to the orthopedic clinic near downtown Sioux Falls. We also followed him to a Car Expo at the local fair grounds where he looked at SUV’s with his wife and son. The claimant did not appear to display any outward indication of a disability during our surveillance.

On Tuesday, 04/26/05, Investigator Jason Sturm conducted the surveillance from 6:30 AM until 5:27 PM. At 8:35 AM, Mr. Claimant walked out of his residence and retrieved his newspaper and then he walked back inside. At 10:20 AM, he left residence and drove to Worthington, MN which is 65 miles away. He picked up a hitchhiker just outside of Benson, SD and drove him all the way to a gas station in Worthington. The claimant then went to a residence in Worthington and dug, pried and pulled five fence posts out of the ground. He also used an electric chainsaw on the posts. He worked for nearly an hour, then broke for lunch at Hardee=s. He returned to the project and carried five gallon pails of dirt to fill the holes. The claimant remained inside the residence when we broke off our surveillance.

We obtained 1 hour and 12 minutes of videotape.

On Wednesday, 04/27/05, Investigator Jason Sturm continued the surveillance from 6:32 AM until 3:34 PM. Investigator John Parker, while working on another case in the area, made a spot check at the Worthington, MN address at 6:47 AM. Mr. Claimant’s vehicle was not here. The claimant came out of his residence in Sioux Falls at 7:58 AM to retrieve his newspaper. At this same time a woman dropped off a small girl at the claimant’s residence and then left. At 8:25 AM Mr. Claimant drove to an orthopedic clinic located near downtown Sioux Falls. He was there for 45 minutes. While there, he could not get his driver=s door open so he entered his truck through the passenger side door.

The claimant went home and was inside for a half hour and then he, his wife and the child who had been dropped off that morning went shopping. They stopped at a Starbucks Coffee and then continued to a furniture warehouse on the north side of town where they purchased some furniture. The claimant lifted the child into the box of his pickup while he waited for the furniture at the loading dock. They returned home and the claimant walked over to a neighbor’s house where he remained inside as we broke off our surveillance.

We conducted spot checks at the claimant’s residence at 8:55 PM and again at 10:11 PM. On both occasions we could see lights on inside the residence.

We obtained 13 minutes and 33 seconds of videotape.

On Thursday, 04/28/05, Investigator Jason Sturm continued the surveillance from 6:45 AM until 2:30 PM. At 7:08 AM, the claimant walked out for his newspaper. At 11:02 AM, the claimant, his wife and his son drove two vehicles to the Sioux Falls fair grounds and attended a Car Expo. They looked at Chevrolet Suburbans in the huge lot which had approximately several thousand new vehicles in it. The claimant did not exit the lot where he entered and he did not return home by the time we broke off our surveillance. We were able to get some film of him inside the lot.

We obtained approximately 14 minutes of videotape.

RECORDS-SOUTH DAKOTA DIVISION OF MOTOR VEHICLES

DIVISION OF MOTOR VEHICLES
445 East Capitol Avenue
Pierre, SD
We checked here to determine what vehicles  were registered to Mr. Claimant. We found the following:

Vehicle #1: A red 2003 Chevrolet pickup truck with SD plate # 1AA-111.

Vehicle #2: A white 2001 Acura sedan with SD plate # 2AA-222

Vehicle #3: A green 1997 Pontiac Grand Prix with SD plate # 3AA-333.

REFERENCE SOURCES

NOTE: We conducted a nationwide database search and found Mr Claimant has resided for the past 27 years in the Sioux Fall, SD area.

DIRECTORY ASSISTANCE
411-Cingular Wireless
This service has the claimant's telephone number listed (605) 222-2222 and his address as 1122 Anywhere STret in Sioux Falls, SD 57100

SURVEILLANCE

THURSDAY
4/26/05
6:30 AM Investigator Jason Sturm arrives in the area of the claimant's residence. His residence is a two-story multilevel home with a three-car attached garage. He has a large deck on the back side of the house. There are no vehicles parked outside here. We set up in a surveillance position on Steeple Street just west of the claimant=s residence.
 
  8:35 AM The claimant exits his residence through the front door and walks to the mailbox to retrieve a newspaper.  He is wearing a dark bluish green sweatshirt and the same color sweat pants and tennis shoes.  He carries the newspaper in his right hand as he easily walks towards the entrance of his residence.  The claimant then switches the newspaper to his left hand as he opens the door with his right hand and he walks into the residence and out of view.  The claimant did not show any sign of having a disability while walking to and from his residence. 
  10:30 AM The claimant backs his red Chevrolet pickup with South Dakota license plate number AA11-111 out of the third stall of the three-car garage.  He then departs the area and we pursue him. 
 
  10:39 AM We are just on the north side of Benson, SD where the claimant turns on to the on-ramp of Interstate 90 heading east.  He stops there and picks up a hitchhiker. He then continues driving east on Interstate 90 towards the MN border. 
 
  11:25 AM The claimant pulls into a Casey=s gas station in Worthington, MN and he drops of the hitchhiker. The claimant then gets out of his vehicle and walks into the gas station. He is now wearing a pair of black jeans, white tennis shoes, and a blue sweatshirt with CSI written across the back of it.
 
  11:29 AM The claimant exits the convenience store, walks to his pickup and drives out of the area.
 
  11:31 AM He pulls up to a residence at 1111 Somewhere Avenue in Worthington, MN.  We later find out that this residence is registered to a Mr. Someone, an older man.  The residence is a yellow rambler with a wooden deck in front and a wooden fence around the yard.  There is a two-car garage located just behind the residence. 
 
  12:06 PM The claimant exits the residence with the older man.  The claimant gets into his pickup, drives it around the corner and parks it halfway on to the boulevard at the residence across a street from the older man’s residence.  The claimant gets of his vehicle, opens up the back cover and pulls out a shovel and starts digging white fence posts out of the ground.

  12:11 PM The claimant then walks across the street and out of view
 
12:13 PM He walks back over to the fence posts with a pair of gloves on and continues trying to wiggle the fence posts back and forth and also dig around it to try to get them out of the ground. The claimant is moving fluidly and he does not show any sign of having any type of disability.


 

12:22 PM The claimant then walks over to his pickup truck, takes out an electric chain saw and begins cutting into the fence posts.
 
  12:34 PM He continues digging around the fence posts and pulling them out by wrapping both of his arms around the fence posts, squatting down and lifting them out of the ground. He is also trying to pry them out with a piece of iron of some type and also his father is hooking a chain to them and trying to loosen them up so the claimant can pull them out of the ground.
 
12:47 The claimant is now down on his knees trying to get the bottom half of a stump out that they cut in half with the chain saw.  He pulls it out of the ground with both of his hands. 


 

  12:49 PM The claimant continues digging around one of the posts while his father backs up with the lawn mower tractor and chain and tries to loosen the posts so the claimant can pull it out of the ground.
 
12:52 PM The claimant and the older man pull the stump out of the ground using both hands.  He then throws the stump approximately five feet away from his body. 


 

12: 55 PM A vehicle pulls in front of us and blocks our view. We have to depart the area for a few minutes and then return. As we are about to turn down the street we observe the claimant and his father leaving the area and we follow them.
 
1:08 PM The claimant and his father pull into a Hardy's near downtown Worthington.  We return to the claimant's father's residence and watch for them to return. 
 
1:58 PM The claimant and his father return back to the residence. The claimant is filling the holes up with five gallon pails of black dirt.
 
2:00 PM The claimant continues to fill the holes up with black dirt by dumping it into the hole and then using a hoe to flatten out the dirt and the grass.
 
2:03 PM The claimant then picks up the remaining fence posts and carries them over to the boulevard for disposal.
 
2:10 PM The claimant is now done digging out the posts and filling the holes up with dirt. He now begins to coil up one of the extension cords. He grabs the five gallon empty pails and puts them in the back of the truck along with the extension cords and the other tools that he used.
 
2:13 PM The woman who lives at the residence arrives back home with her child and talks to the claimant and his father. The claimant then walks over to the front of the house and appears to be looking at the roof like possibly in the future he might replace the roof.
 
2:16 PM The claimant then walks out of view.
 
2:17 PM He walks back in view carrying what appears to be a soda pop in his right hand as he opens up the passenger door of his pickup.
 
2:18 PM The claimant then walks into the older man's residence.
 
2:51 PM He walks out of the residence carrying some objects in his left hand as he walks towards his vehicle. They then walk around the corner and out of view.
 
4:07 PM The claimant then comes back in the view and walks back into the residence.
 
4:54 PM The claimant walks to his vehicle, gets in, backs it up, pulls it in front of the residence and picks up the older man and a woman and drives away.
 
5:27 PM The claimant has not returned with his father or mother and we break off the surveillance for the day.
 
WEDNESDAY
4/27/05
6:32 AM Investigator Jason Sturm arrives in the area of the claimant=s residence. None of the claimant's vehicles are parked outside. The shades on the front of the residence are closed. The ones on the back are open as they were yesterday. We set up in our surveillance position.
 
7:58 AM The claimant exits his residence wearing black pants, tennis shoes and a black long sleeved shirt. He walks to his mailbox, picks up the newspaper and then walks back into his residence. The claimant continues to move showing no sign of having a disability.
 
7:58 AM A woman in a white GMC pickup with SD license plate number 4AA-444 pulls into the driveway and drops off a small young girl.  It appears that Mr. Claimant is going to baby sit for this woman. 
 
8:02 AM The woman leaves the claimant's residence without the child.
 
8:25 AM The claimant backs his red Chevrolet pickup out of the garage and drives away.
 
8:37 AM He arrives at the orthopedic clinic located near downtown Sioux Falls. The claimant walks into the orthopedic clinic without any sign of a disability. The orthopedic clinic is located on 23rd Street and 10th Avenue in Sioux Falls, SD.
 
9:32 AM The claimant exits the orthopedic clinic and he walks to his vehicle.  It appears that the claimant cannot get his driver=s side door unlocked as he tries to get into his vehicle.  He then walks around to the passenger=s side, opens that door and then gets in through the passenger=s side and he drives away.
 
9:40 AM He stops at a Centex gas station
 
9:42 AM The claimant exits the Centex gas station. He is still having trouble opening up his driver=s side door as he is carrying what appears to be a couple of bottles of cola in his right hand. He walks around, unlocks his doors, closes the passenger=s door and then walks around and gets into the driver=s side door and drives out of the area.
 
10:02 AM The claimant is now back at his residence.
 
10:40 AM The claimant departs the area in his Chevrolet pickup along with his wife and the young girl.
 
10:47 AM The claimant then pulls into the parking lot of a Hy-Vee grocery store/Starbucks Coffee. He goes inside and out of view.
 
11:17 AM The claimant walks out of the Starbucks Coffee shop carrying a cup of coffee in his left hand and holding the little girl=s hand as they walk through the parking lot and towards his truck.
 
11:18 AM He gets into his truck and deports the area.
 
11:36 AM The claimant pulls into a furniture outlet USA on the north side of town and goes inside of the furniture store.
 
12:14 PM He exits the store through the front door, gets into his truck and drives around to the back to a loading dock.


 

12:17 PM The claimant then gets out of his truck, walks around to the back of his pickup truck, puts both hands on the hardcover and lifts it up over his head and lowers the tail gate. He grabs the child, picks her up and puts her into the box of the pickup truck.

 
 

12:19 PM One of the workers at the furniture store comes out with a flat piece of cardboard and lays it down in the box of the pickup truck.
 
12:21 PM We have to move our van since we are blocking traffic and we decide to depart the area and return to the claimant=s home so we can possibly videotape him carry the furniture from the pickup and into his residence. 
 
12:40 PM We arrive back at the claimant=s residence and take up our surveillance position.
 
1:32 PM The mail is delivered to the claimant's residence.
 
12:57 PM The claimant arrives back at his residence and he pulls directly into the garage and out of view. His wife then comes out of the garage, walks to the mailbox, retrieves the mail and then she walks back in through the garage and out of view.
 
2:45 PM The claimant walks out of the garage and he goes over and enters the neighbor's side garage door.
 
3:34 PM The claimant remains inside the neighbor=s residence and we break off the surveillance for the day.
 
8:55 PM We conducted a spot check at the claimant’s residence and observe lights on inside the residence.
 
10:11 PM We conduct a second spot check. Again, there are lights on inside the residence.
 
THURSDAY
4/28/05
6:45 AM Investigator Jason Sturm arrives in the area of the claimant's residence. There are no vehicles parked outside. The shades are still pulled in the front and on the west side of the residence. We set up in our surveillance position.
 
7:08 AM The claimant exits wearing a black sweatshirt and black sweat pants. He walks to his mailbox to retrieve his newspaper and then he walks back inside. He continues to walk in a normal gait and he does not show any sign of having a disability.
 
10:16 AM The garage door opens and the claimant=s son walks out. He is approximately 5'09-5'10 tall and about 250 pounds with a shaved head. His son and his wife then get into a white Acura with South Dakota license plate number 2AA-222 and they depart the area. The claimant remains inside of his residence.
 
10:55 AM The claimant's wife and son return in the white Acura and pull the vehicle into the garage.
 
11:02 AM The claimant and his wife leave their residence with the claimant driving the white Acura. His son backs a green Pontiac Grand Prix with South Dakota license plate number 3AA-333 out of the garage. They depart the area and we follow them.
 
11:21 AM The claimant, his wife and his son arrive at the Sioux Empire Fair in Sioux Falls, SD. Behind the grandstands they are having a very large Car Expo in a parking lot.  It is filled up with thousands of brand new vehicles, anything from BMW's to Hyundai's. 
 
11:26 AM We drive by the claimant and his son as they are parked in one of the isles where the GMC Yukons, Yukon XLs and Chevrolet Suburbans are parked. It appears that the claimant or his son is interested in buying one of these.  This is a very difficult place to try to get in a surveillance position with a view of the claimant.  Every time we try driving down an isle, he would either switch over to another isle or we would have to drive by him. We tried sitting in a position nearby but we kept getting bothered by salesmen driving around in Golf Carts trying to sell vehicles.  We depart the area and take up a surveillance position near the entrance into the fair grounds. 
 
1:10 PM The claimant has not driven by our position so we enter the parking lot and look for the claimant=s vehicle. We do not find the claimant's vehicle and it appears that they went out a different exit. We depart the area and go back to the claimant's residence.
 
1:51 PM We call the claimant's residence and he is not home. There is no answer or answering machine. 
 
2:30 PM The claimant has not returned home and we break off the surveillance and leave the area.
 

CUSTOMER CONTACT

On Tuesday, April 26, 2005 Supervisor Jon Kinard gave John Smith of Insurance Co USA an update with the results of our surveillance.


On Wednesday, 04/27/05 Investigator Jason Sturm called John Smith of Insurance Co USA and gave him a full update on the claimant=s activities. He authorized a third day of surveillance to be done on Thursday 04/28/05.

On Friday 04/29/05, Jon Kinard left a voice mail message for John Smith of Insurance Co USA with the final results of our surveillance.

ENCLOSURES

1. One Video CD, a copy of the original surveillance tape.

Jason Sturm
JAS/pc

CUSTOMER LOG-IN

To view a clip of this video tape, go to www.nrsgetsresults.com and click on the Customer Log In page. Enter the following information:

Username: demo
Password: demo

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NOTE: Please feel free to log in with this demonstration account and see the sample surveillance footage that accompanies this sample report.
 

 

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