A common mission for private investigators is investigating insurance fraud. Private investigators need to use all their resources and ingenuity to track them and unveil employee’s fraudulent schemes as people can get very creative when committing fraud. Advanced Private Investigator & Security of Miami, FL would like to discuss the tactics private investigators employ in uncovering worker’s compensation fraud.
What are Examples of Workers Compensation Fraud?
Because it doesn’t need complicated plans and tools, workers compensation fraud is probably one of the most popular types of fraud. By exaggerating their injuries or illness suffered at work, worker’s compensation fraud can be defined simply as the type of fraud committed by an employee to gain an advantage, money or other benefits. Worker’s compensation fraud can be committed by employers, and even healthcare providers too, contrary to what many people believe. While healthcare providers choose to bill for services they have never performed, employers that commit workers compensation fraud usually underreport their payrolls or misclassify their employees to pay lower premiums. When someone intentionally makes a false statement or conceals information to receive benefits or prevents someone from receiving their rightful benefits is how workers compensation fraud happens. Research has found that 1 in 4 Americans have no problem with defrauding insurers and 1 in 4 construction workers are paid off the books to avoid paying premiums; this affects all of us. Because of fraud, it is estimated that 1 out of every $10 spent on premiums is lost. Hiring a private investigator to uncover such fraud is becoming more common among businesses.
Workers Comp Private Investigator Tactics
Below are some of the tools private investigators use to determine whether someone is committing workers compensation fraud.
Incident Assessment. To decide if it really happened the way the employee described it, a private investigator will recreate the accident. The internal and external factors are analyzed to try and find the person at fault. Also, to corroborate their statements and see if the facts coincide, private investigators will also interview witnesses and other employees. The investigation of frauds committed by employers is also used with this tactic. To understand how the accident happened in the workplace and work environment is basically the goal of the private investigator.
Surveillance. An important role in a workers compensation fraud investigation is surveillance.
To see if a claimant’s mobility, daily routine and/or quality of life is affected by the alleged injury or illness, private investigators will follow the claimant and document their activity. Surveillance proves to be a decisive factor for many workers compensation fraud investigations, though this is a time-consuming method. A private investigator can prove or disprove the legitimacy of an injury with photos and/or videos. This tool can also be used to investigate employers.
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A private investigator can discover if the employer has a pattern of negligent employer behavior if an employer is suspected of committing workers compensation fraud. Call Advanced Private Investigator & Security of Miami, FL and let us assist you if you suspect workers compensation fraud.
