Like nearly every other business owner he knew, Lance paid close attention to the bottom line. He felt responsible for employees working in his chain of convenience stores. Many of those employees had been with Lance for more than a decade. In fact, Lance believed his stores were surviving the economic crunch because employees were friendly and fair to customers, just as Lance was friendly and fair to workers.
That was exactly why Lance was upset about a workman's compensation claim filed two months ago by a new employee. According to the claim, the employee injured his back and neck when he slipped and fell on a freshly mopped floor. Other employees told Lance the wet area was marked with a cone and no one in the store, not even customers, witnessed the employee's fall.
In vain, Lance investigated hours of store video but found no evidence of the fall. That's when Lance definitely smelled a rat. And the rat was squeezing Lance's already tight budget for workman's compensation insurance that he might not actually deserve or need.
In his own research, Lance found that neck and back injuries were the most common ones to report when an individual was scamming their employer. The more Lance thought about the situation, the angrier he became.
He talked with his insurance agent and learned there had been some red flags for the insurance company, too. They were on alert and had already begun an investigation.
Lance didn’t want a long, drawn out investigation during which the worker was getting benefits – and adding to Lance’s workers comp claims experience and therefore, to his premiums. So he made an appointment with .
Could they prove that Lance's employee was faking injuries?
The professionals at nodded and smiled, because if it was a case of workers compensation fraud, they knew how to uncover evidence to prove it. Their track record for these types of fact-finding missions was spotless. Investigators began a workers compensation fraud investigation.
was able to discover that the employee had filed workers compensation claims twice before. That prompted investigators to use surveillance equipment to document his activities. Within days, had video for Lance to supply the insurance company and eventually utilize in court. Investigators had documented each instance of the severely injured employee, riding a motorcycle, cleaning gutters atop a ladder and shoveling loads of mulch from his drive into gardens.
Sometimes investigators have to go so far as to document medical services and medical service providers as scams can reach that level. Insurance fraud is a huge problem and dramatically increase premiums for every insured. Lance knew that and took action.
-Brenda McGinley, CEO, All in Investigations, All in Investigations