Fraudulent claims of injuries on the job are common. They hurt businesses by affecting insurance premiums and hurt insurance companies by paying out money for claims that are not legitimate. Workers’ compensation fraud is not just a serious crime – it’s a felony. Short of prosecuting those who commit fraud after they have been paid money, there are many steps that can be taken to win a workers’ compensation case from the beginning.
Have a Plan in Place
It is important to have a procedure that all employees are aware of so that any injury is documented as thoroughly as possible. This documentation will give an insurance adjustor every possibility of denying a fraudulent claim. Insurance companies, likewise, should encourage companies to have a plan in place.
Make Sure Injured Employees Visit the Doctor
Anyone who is injured needs to see a doctor immediately, so the extent of the injury is known. Too often, an employee will claim they are hurt at a later time, and it is difficult to know if they received the injury at work or on their own time.
Have an Employee Drug Tested
This is nothing personal and should be applied to any and all workers who have been hurt on the job. An employee may claim they were injured on the job, but it may be due to being under the influence of drugs. This is not covered by workers’ compensation policies. The best time to test for drugs is when the employee visits the hospital after an injury.
Use a Private Investigator
One of the problems with worker’s compensation insurance is that even when the case is well documented, an employee can still commit fraud. Certain injuries are difficult to diagnose, and when they are diagnosed, it may not be possible to determine how much pain an individual is in or their ability to do their job.
Exaggerating an injury to get workers’ compensation is considered fraud, and it is the most common form of workers’ compensation fraud. The best way to determine this type of fraud is to hire a workers comp fraud investigator to do a sub rosa investigation.
What a Workers Compensation Investigator Can Do
Whether it is a business or an insurance company, a private investigator has the ability to do background research on an individual to determine their past history as it relates to insurance fraud. More importantly, they have the ability to conduct surveillance on an individual to attempt to discover if any fraud is being committed.
In a story report by ABC news, a man in Florida claimed to be mentally handicapped due to a workplace injury, but a sub rosa investigation found that the man was driving a car, hunting and playing golf. It was video surveillance that documented this case of fraud.
In another story report by ABC news, a woman claiming she could not stand up, reach or grab for anything was spotted on the television show The Price is Right. She not only appeared to be healthy, but spun the big wheel twice. This was found out through a private investigation.
Our California workers comp fraud investigators are top notch, and if an employee is committing fraud, we are likely to discover it via surveillance. Our services are completed by investigators that are both knowledgeable and professional. We understand what we are allowed to do legally in the course of our investigation, and therefore, we maximize our effectiveness without creating legal problems for our clients. Whether you are a business or an insurance company, our services can help you investigate workers’ compensation fraud and win your case.
Bruce Robertson
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