Catch the Worker’s Comp Fraudsters!

by Wolfes Investigations Specialized Private Investigators to Serve in Los

Worker’s Compensation fraud occurs when an employer, healthcare provider, or a claimant knowingly lie in order to gain an advantage, savings, money or other benefits. While many people believe that workers compensation fraud solely consists of employees lying about or exaggerating their injuries, workers compensation fraud can involve both employees and employers.

Worker’s Compensation Fraud: a Two-Sided Monster in the Corporate World

The costs and consequences associated with worker’s compensation fraud are growing. Worker’s compensation fraud accounts for ¼ of all insurance fraud. Both employers and employees are contributing. Find out how and what cost below.

Employee Side Fraud Cases:

· Injuries with no witnesses

· Delays in reporting injury

· Delays in seeking medical treatment and/or missed appointments

· Injury while off work

· Financial stress at home

· Filling multiple claims

· Injury at time or termination

Employer Side Fraud Cases:

· Denial of valid claims

· Late issuing of disability checks

· Misclassification of work force and the nature of the work being done by employees

· International refusal to purchase insurance for employees

· Making examples of employees who have submitted claims

· Issuance of Ghost Policies to independent contractors who are actually employees

Hiring a Private Investigator in Los Angeles to Conduct Worker’s Compensation Investigation

It is estimated that worker’s compensation fraud accounts for ¼ of all insurance fraud. To balance the cost of payouts associated with these fraudulent claims, insurance companies must charge more for premiums to remain profitable. These costs almost always fall on the business owners. For small to medium-sized firms, this can prove to be devastating and in extreme cases this may lead to laying off employees or closing the business.

Why an Employer Should Hire a Private Investigator in Los Angeles?

Insurance companies will often use a private investigator in Los Angeles for significant claims or ones where fraudulent patterns are easily identified, but smaller claims can often fall through the cracks. These claims still affect your business and premiums, so quick action should follow when you believe an employee has submitted a false claim. It takes more than a hunch; however, to stop payments on a fraudulent claims. You are going to need hard evidence that can be uncovered with specialized tracking and investigative techniques like the ones used by an experienced private investigator in Los Angeles.

Some of the Effective Strategies A Private Investigator in Los Angeles Use Are:

ü Claimant Interviews: Investigators don’t want the subject to know that their behavior is being monitored; so, rather than a one-on-one personal interview; questionnaires can be supplied to the claimant to evaluate the answers with previous statements given at the time of the alleged accident. Inconsistencies can serve as evidence against the validity of the claim.

ü Accident Research: Based on the reports given at the scene by the claimant and other individuals present, an experienced private investigator in Los Angeles will often find recreating the scene as an advantageous approach to uncovering falsities of the accident. Much like a crime scene investigator, the accident can be tested and reenacted to test the circumstances surrounding the alleged injury.

ü Background Checking: Individuals who submit fraudulent claims typically have a history of the same fraudulent behavior. This is where a background check can look for previously filed claims. A long history of on the job accidents is one of the primary signs that the situation should be further investigated. During this time, criminal history will also be evaluated to look for patterns in behavior related to unethical activities.

ü Private Surveillance: One of the most effective strategies for proving a fraudulent claim is catching the individual red-handed in activities their injury should prevent them from doing. For example, if a claimant allegedly hurt their back to the point where they are unable to walk, work, or function without pain, and during surveillance the individual is seen moving furniture or working a physical job under the table, you now have absolute irrefutable proof that can be presented in court.

If you believe an employee has committed worker’s compensation fraud, get in touch with the experienced private investigators in Los Angeles at Wolfe’s Investigations. Our team will meet with you to gather all the information surrounding your case and develop a comprehensive investigative strategy based off of the specific circumstances surrounding your case.

To schedule a consultation with one of our private investigators in Los Angeles, call us today or head over to the official site – Wolfe’s Investigations!