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 a worker exaggerates injuries and collects for medical care and days off, but we also know that workers’ compensation investigations, like other investigations, can take many different twists and turns, revealing truths you may never have seen coming.
- Surveil a claimant
- Investigate premium payments
- Surveil and document appointments and activities
- Document financial transactions and accounts.
And with our experience, the assignment can include the patient, the employee, the medical care providers, the employers and others connected with the case. Workers’ compensation fraud cases can be simple, or they can be very complex with many moving parts. What makes them interesting is that the initial simplicity can turn into a bowl of spaghetti, full of leads going in all sorts of directions.
Some insurance companies simply deny claims, while others pursue legal remedies. We deliver the facts to the client, which is often the insurance company, but sometimes their attorney, and let them make that decision.
Insurance companies know that they can count on to get the accurate facts they need to make decisions that are right for their customers.
-Brenda McGinley, CEO, All in Investigations, All in Investigations