A type of insurance that protects employees who develop an illness as a result of their job environment or are injured on the job is known as workers’ compensation insurance, or workman’s comp. To provide wage replacement during recovery and to pay for medical expenses related to the illness or injury is what it is designed for. In cases where treatment and/or recovery is likely to be extensive and a lump sum payout is appealing to both parties, workers’ compensation settlements are common. Today, we at Advanced Private Investigator and Security of Miami, FL would like to elaborate on signs of workers compensation fraud.

What Workers Compensation Investigations Look For?

For what constitutes a workplace-related illness or injury, there are of course, rules. For instance, illnesses and injuries cannot be self-inflicted or in violation of a company’s policy. With a host of creative ways of committing workers’ compensation fraud and finding ways to score a tax-free settlement, unfortunately people are determined to break rules for personal gain. There is significant financial and productivity losses however, with fraudulent workers’ compensation claims. Below are warning signs that your employee, or even a ring of employees are guilty of workers comp fraud.
No Observers. More often than not, when the where, why, when and how the illness or injury occurred has no corroborating witnesses, it suggests a fraudulent workers’ compensation claim.
Implausible Scenario. Though anything is possible, some things are simply unlikely. It may well be worth investigating if an employee reports an incident description that doesn’t seem plausible.
Conflicting Accounts of the Event. Whether witnesses interpreted the scenario differently from the reportedly illness or injured person or if the person changes details in every report.
Monday Reports. An incident that occurred on Friday afternoon that wasn’t reported until Monday morning is described by the fraudulent workers’ comp claims.
Social Media Posts. Social network profiles are often followed among employees and even employers, and in many cases, the private settings are not even enabled. Catching an employee going rafting over the weekend or giving details about an illness or injury that happened outside of the workplace; the social media accounts provide a documented timeline.
Conflict in the Reports. Unmatching medical and employee report.
Treatment is Declined. Many will decline medical attention or diagnostic treatment when they want to conceal the truth about the existence or severity of their illness or injury.
Unreputable Providers. To get some easy cash, some medical providers are in on the act and will corroborate a claim. Note the reputation of the medical provider. Or if they switch primary care physicians they may be up to something.
Frequently Changing Jobs. Resumes and LinkedIn profiles can be very telling. This can be a telling sign that they move jobs to scam their employers with false workman’s comp.
Transitioning Jobs Suddenly. Before or after the conclusion of a seasonal job, a resignation/termination or furlough/layoff, the fraudulent workers’ compensation claims are often filed.
History of Claims. Several workers’ compensation or other insurance-related claims is a major red flag.

Private Investigator & Security Services in Greater Miami, Sunny Isles, Fort Lauderdale, Boca Raton, Weston, Plantation City & Miami Gardens Florida

If you suspect workers comp fraud, call Advanced Private Investigator and Security of Miami, FL and let our specialists investigate the claims. We will find the truth in the claims and help you determine the accuracy of the claim.