Workers Compensation Fraud Investigation Archives

Investigations: Fact or Fiction

Our results are the truth: Is what we think we see or what we have heard or the way we feel fact or fiction? Investigations are conducted to uncover the truth. A Background Check to learn about an individual, Surveillance to observe activity, Polygraph or VSA for deception, Forensic Analysis for malware and extraction of data, Asset Search for hidden funds or net worth are conducted when finding the truth matters. We want to know if our spouse, boyfriend, significant other is faithful, and if not, we want them to have the courage to be honest about their activities, but that isn’t always the case. How do we find the answers? We want our children to be safe when we drop them off at daycare, [...]

Insurance Fraud Exposed in Surveillance Recordings

Every year, billions of dollars are lost due to people filing false insurance claims. Because that kind of loss tends to trickle downward, the rest of us pay much higher premiums. Unfortunately, there are a lot of dishonest people in the world. They are the ones who torch their own vehicles and then insist that their cars were stolen. They set fire or hire someone to set fire to their homes and businesses. And, you guessed it, they lie about it in an effort to rake in the big bucks. Those who commit workers compensation fraud or disability insurance fraud to collect benefits also very negatively affect the rest of us and the workforce in general. Most of the time, a person files a false [...]

Who’s the Fraudster in Insurance Fraud?

Insurance fraud is a huge problem and insurance companies have gotten a reputation for being hard to work with on insurance claims. They see a lot of fraud and the red flags that pop up are taken very seriously. is called in by insurance companies when they see red flags. We don’t make decisions on cases. Our job is to find facts. Sometimes the facts just keep compounding. In one workers compensation fraud investigation, we were asked to surveil a claimant to determine if the patient was really disabled. Workers comp fraud is everywhere and the premiums are very expensive, in part because of the amount of fraud. Workers compensation investigation can include documenting the claimant’s activity as well as their contact with medical providers. [...]

Surveillance Equipment Documents Workers Compensation Fraud

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 [...]

Hurrying Through Hiring and Skipping Background Investigation Has Consequences

Years ago, Bill learned his lesson, which is the fact that you just can't take anything at face value, especially people. Like all of those lessons that last a lifetime, Bill learned this information the hard way. It happened when he hired two new employees for the city courts system. There had not been enough time to adequately complete the HR due diligence checklist including background investigations, as Bill and his staff would normally do with new hires. At the time, the offices for the heavily populated city were grossly understaffed. The employees were all stressed out and overworked. All anybody wanted, at that time, were a couple of warm bodies to sit in front of the telephones and computers. As luck would have it, [...]

Is it Stress or Is It Insurance Fraud?

By the time Hal met with , he looked downright exhausted, not to mention angry. Nothing in life had been easy since the situation at his company had spun out of control. 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 [...]

Is it Pain or is it Workers Compensation Fraud?

When their employee of less than six months claimed that her back was severely injured during a fall at work, Mary and Ted were alarmed. After all, their entire company was built on safety. In more than two decades of being in business, an employee had never been hurt on the job. But soon after the woman claimed to be too injured to return to work, Mary and Ted began to smell a rat. They spoke to other employees about the incident. Unfortunately no one had seen the woman actually fall. There was no video to review since Mary and Ted had never seen cameras as a necessity in their place of business. Shortly thereafter, the employee filed for workman’s compensation. Following that, Mary and [...]

Workers’ Compensation Fraud Investigation Reveals Complex Web

works with workers’ compensation insurance providers investigating workers’ compensation fraud. Through investigative techniques and surveillance, we often can uncover the truth about claimants and their activities. But that’s not all. The company being insured can come under question. Are the employees and wages being accurately reported? Are claims being processed in accordance with the law? A workers’ compensation investigation can also entail investigation into the medical services providers. In fact, sometimes the investigation is centered on the medical services providers. If that is the case, the workers’ comp fraud costs to the insurance carrier usually increases substantially. That is because the fraud can include many patients and many different insurance carriers. One chiropractor in Pennsylvania was charged with filing fraudulent claims to several different insurance [...]

Workers Compensation Fraud Investigation Leads to Surprises

A recent California case reported in the Los Angeles Daily News proves that workers’ compensation fraud is not just about employees and their claims. No, in this case, the employer was revealed to be the perpetrator of workers’ comp fraud. The employer was found guilty of workers’ compensation fraud and sentenced to 29 days in jail, three years of probation and ordered to pay $110,381 in restitution for failing to accurately report employee wages. He was understating wages in order to pay a lower premium for workers’ compensation insurance. He also filed at least one claim during the time in question for an employee’s injury without paying insurance on the employee’s wages. is familiar with the workers’ compensation fraud investigation everyone thinks about – where [...]