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 companies. During the process, it was uncovered that he evaded tax payments on more than $800,000 in income. He pleaded guilty and was ordered to pay approximately $836,000 in restitution.
The thing is that a workers’ compensation fraud investigation can be just the start of the truth about fraud. In this case, the entire situation unraveled because an investigation was requested because the doctor was not returning one of his employees to work – that was one of HIS employees.
Workers’ compensation fraud investigations can cover:
- The worker
- The company employing the worker
- The medical services provider
A workers’ compensation investigator with experience recognizes leads and does not discount any detail as insignificant – because he knows it may turn the case in a new direction that uncovers all the fraud, not just a bit of it. He knows that workers’ compensation fraud is not restricted to an employee receiving benefits fraudulently – being well enough to work and return to normal activities. That, although significant in the workers’ comp fraud world, can be just the tip of ice berg.
No matter how complex the case, will put on their jackets and take a look at the ice berg!
-Brenda McGinley, CEO, All in Investigations, All in Investigations