Workers Compensation Fraud Investigations Archives

Accusations Proved False with Investigator’s Facts and Evidence

In every professional capacity, staff gathers the truth. But quite often, the general public assumes that the majority of our time is spent finding hidden divorce assets and proving workers compensation fraud. Because of our stellar reputation with lawyers, a defense attorney and his client appeared in our office, desperate for our assistance. The client, Jon (name changed), was a well-known professional athlete who had been arrested and charged with rape. To make the matter even worse, the victim was a minor female, age 17. As you can probably guess, the media was in a frenzy. Jon and his defense attorney requested assistance from our office, to prove Jon’s innocence. Jon admitted that yes, he briefly attended a party where he met and spoke with [...]

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 [...]