By the way, “the situation” involved Hal's very successful real estate company and Gwen, his very difficult employee. Gwen was hired to be an administrative assistant after Hal explained that the role could be busy and stressful. Gwen had assured her new employer that she could very confidently complete all of the tasks. Hal was so impressed with Gwen that he did not follow through with the routine background investigation.
Five months after Gwen's probationary period ended, she began to frequently call in sick. Her absences gradually increased to once or even twice each week. When Hal decided to meet with her to discuss her work performance, he learned that Gwen left work at noon that day. She also contacted human resources to announce that she was suffering from anxiety attacks and agoraphobia; that Hal was so demanding she now suffered too much to work.
A week later, Gwen filed for workers compensation benefits. A week after that, she filed a lawsuit against Hal for sexual harassment. Hal was absolutely enraged. He didn't believe a single word of his employee's claim to suffer from anxiety and agoraphobia. He was also livid that she added sexual harassment charges, just to sweeten the pot.
Workers compensation insurance is very expensive for businesses and claims increase the premiums. Hal was also concerned that Gwen could tarnish his reputation in the community. We have seen clients in similar situations simply settle and pay off disgruntled employees. Not Hal. He wanted proof that Gwen was attempting to con his company.
In workers compensation fraud investigation, surveillance equipment is an important tool. Surveillance was conducted every day that Gwen called in too sick to work. The second day she left her apartment and was followed to a beauty salon where she got her hair styled and her nails done. She did a little shopping and later enjoyed lunch with another woman at a downtown bistro. The entire day was recorded on video – date and time stamped.
A background investigation was initiated and it was noted that she had lived in several states and had had jobs and debts in three other names. Investigators also looked into prior claims through insurance data bases using all the names. The research was fruitful and showed a pattern of insurance claims, including two for workers compensation and one for a slip and fall claim against a retail store for disability and medical expenses...each one under a different name and in a different state.
Insurance fraud, whether it is workers compensation fraud or disability insurance fraud, is costly – and illegal. Once insurance companies are on the trail of someone making fraudulent claims, they pursue the con artist to the end.
Her downfall was sealed by her activity on social media platforms. Investigators were able to follow her activities and posts, which did not sync with someone suffering anxiety and agoraphobia. She even provided evidence against herself by posting photos of her celebrating several events in crowds of people at popular night spots.
At the conclusion of the investigation, Hal had sufficient admissible evidence for his attorneys to not only defend Hal’s reputation and business, but to provide to insurance carriers who were eager to prosecute as well.
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-Brenda McGinley, CEO, All in Investigations, All in Investigations