It is estimated that Workers’ Compensation fraud accounts for 1/4 of all insurance fraud. To balance the cost of payouts associated with these fraudulent claims, insurance companies must charge more for premiums to remain profitable. These costs almost always fall on the business owners. For small to medium-sized firms this can prove to be devastating, and in extreme cases this may lead to laying off employees or closing the business.
Why an Employer Should Hire a Private Investigator
Insurance companies will often utilize a Tampa insurance fraud investigator for significant claims or ones where fraudulent patterns are easily identified, but smaller claims can often fall through the cracks. These claims still affect your business and premiums, so quick action should follow when you believe an employee has submitted a false claim. It takes more than a hunch, however, to stop payments on a fraudulent claim. You’re going to need hard evidence that can be uncovered with specialized tracking and investigative techniques like the ones used by our insurance fraud investigators in Tampa.
At Darwin Securities some of the strategies we use are:
1. Claimant Interviews
Investigators don’t want the subject to know that their behavior is being monitored, so rather than a one-on-one in person interview, questionnaires can be supplied to the claimant to evaluate the answers with previous statements given at the time of the alleged accident. Inconsistencies can serve as evidence against the validity of the claim.
2. Accident Research
Based off the reports given at the scene by the claimant and other individuals present, investigators will often find recreating the scene as an advantageous approach to uncovering falsities of the accident. Much like a crime scene investigator, the accident can be tested and reenacted to test the circumstances surrounding the alleged injury.
3. Background Checks
Individuals who submit fraudulent claims typically have a history of the same fraudulent behavior. This is where a background check can look for previously filed claims. A long history of on the job accidents is one of the primary signs that the situation should be further investigated. During this time, criminal history will also be evaluated to look for patterns in behaviour related to unethical activities.
4. Private Surveillance
One of the most effective strategies for proving a fraudulent claim is catching the individual red-handed in activities their injury should prevent them from doing. For example, if a claimant allegedly hurt their back to the point where they are unable to walk, work, or function without pain, and during surveillance the individual is seen moving furniture or working a physical job under the table, you now have absolute irrefutable proof that can be presented in court.
If you believe an employee has committed Workers’ Compensation fraud, our Tampa insurance fraud investigation team will meet with you to gather all the information surrounding your case, and develop a comprehensive investigative strategy based off of the specific circumstances surrounding your case.
To schedule a consultation with one of our investigators, please call us today at (813) 468-3504 or fill out our contact request form.