Accidents do happen, however, for everyone involved, injury in the workplace can be costly. When an employee fabricates or exaggerates an injury it can be incredibly and unnecessarily costly for business owners. Unfortunately, worker’s compensation fraud is all too common in the workplace today. To protect your company from fraudulent claims, we at Advanced Private Investigator & Security of Miami, FL would like to share the common signs of Worker’s Compensation Fraud.
Inconsistency with the Employee’s Workplace Story
An inconsistent story from the employee in question is one of the easiest ways to determine whether or not you’re dealing with worker’s compensation fraud. To help protect you and your company from claims fraud, it’s important to get all of the information of the reported accident on file. Inconsistencies, details changing in one report to the next, omission of facts, and so forth indicate a possible fraudulent claim. In order to determine whether or not their account of the accident conflicts with the injured employee’s story, try to ask other employees if they were present when the alleged injury took place. Especially when it comes to working with your insurance company, you should take all necessary steps to validate and confirm every detail, though you do need to keep in mind there may be a reasonable explanation for why they are misremembering.
No Witness to Corroborate Employee’s Story
Your company policy has established safety protocols that require multiple people to be present for certain job functions and duties if you work in a labor-intensive industry like construction or in a warehouse setting. It’s likely that insurance companies will deny the comp claim if there are no additional witnesses to a work-related injury.
Employee Waits to Report Incident
Precisely when the injury was reported is one reason you may question the validity of injury claims in your company. Since it can be an indication that the injury did not actually take place on the job, late reporting and employee delays can be a serious red flag when it comes to false claims in the workplace. In order for the employee to receive compensation benefits, each state has a differing policy on when workplace injuries must be reported.
Medical Treatment is Refused by Employee
Employees should not hesitate to seek medical treatment immediately if they are seriously injured. A sign they have something to hide and may be attempting to receive unemployment benefits is if they refuse immediate medical treatment. It should also be noted that by claiming to provide medical care in order to be paid by the insurance company and health care providers can also be guilty of worker’s compensation fraud. In addition to any past medical history, it is essential to request proof of any medical expenses acquired throughout the claims process.
Employee has a History of Claims
To determine whether or not the employee in question has a history of filing claims, using a private investigator can help. We can dive deeper into their past employment and claim history to expose potential patterns by conducting comprehensive background checks.
Handling of Suspicious Claims
You should take the necessary next steps to protect you and your business before you accuse an employee of fraud. Make certain to report the suspected employee to a state agency. This may differ from state to state. To your designated agency, you can report a false injury claim, fraudulent insurance claim or other form of fraud.
Private Investigator & Security Services in Greater Miami, Sunny Isles, Hialeah, Fort Lauderdale, Pembroke Pines, Hollywood, Miramar, Boca Raton, West Palm Beach & Miami Gardens Florida
If you suspect fraudulent worker’s compensation claims, call Advanced Private Investigators & Security of Miami, FL today to begin an investigation and we will find the truth and evidence to back it up.
