Organized fraud rings, doctors, lawyers, and business owners, employees and ordinary people are just a few of the many faces of workers compensation fraud. Estimates of the cost of fraudulent work-related claims range from $1.5 billion to $9 billion dollars annually. Insurance fraud occurs in simple and complex schemes and often requires a difficult and lengthy worker’s compensation investigation to sort out the facts.
Statics show that every $1 spent on surveillance saves more than $9 in claim payments.
There are several warning signs that a workers’ compensation claim may be fraudulent. These include Monday morning reports of an injury that happened the previous week, conflicting descriptions of how the injury occurred, no witnesses and a history of claims.
At Rockwell Investigation & Consulting, the goal of our private investigators is to reveal truth by gathering court-admissible evidence through a well-planned, thorough workers compensation investigation. When the truth has been discovered, the facts are documented and presented in a clear concise fashion that is trial-ready. When it comes to surveillance, there is no substitute for experience.
The Benefits of Surveillance
Video surveillance can have a devastating impact on a workers’ compensation case when the claimant is captured on video operating outside of his/her restrictions. Photographic and video evidence is paramount in substantiating fraudulent claims. Our findings will be professionally presented in a clear and concise manner to aid in any legal proceedings. You will receive a written report, video documentation and audio-recorded statements that you can take to trial if need be.
Surveillance for Worker’s Compensation Investigations will:
- Confirm or dispute the limitations of claimant’s mobility
- Monitor and verify any improvement of a claimant’s condition
- Verify the accuracy and validity of claims
- Greatly diminish your costs and exposure
Rockwell I & C: Experienced and Trained to Handle Multiple Types of Claims
- Workers Compensation Claims Investigations
- Automobile Liability Claims Investigations
- General Liability Investigations
Marlene Rockwell has over 20 years of experience in the insurance fraud industry and has conducted thousands of insurance fraud investigations. She knows the in’s and out’s of a successful and artful surveillance. All of Rockwell’s investigators are seasoned and are able to perform all aspects of the investigation in the professional manner possible.
Red Flags of Possible Worker’s Compensation Fraud or Abuse
While most workers’ compensation claims are legitimate, some are inflated or fraudulent. These are just a few red flags that could indicated fraud:
Provides multiple versions of how the accident occurred or has injuries that are inconsistent with facts of accident.
Refuses medical tests or examinations to confirm an injury.
Stays out of work longer than the doctor prescribed.
Protests excessively about a modified position or returning to work and never seems to improve.
Has a suspicious prior history of reporting subjective injuries.
Has a questionable identity, residence or contact information.
Was experiencing financial difficulties prior to submission of a claim and inquiries about a quick claim settlement.
Is retiring, on probation, involved in a labor dispute, disgruntled, a poor job performer or subject to disciplinary action.
Is a new employee, nomadic, a seasonal worker or on short-term employment.
Is never at home, does not answer telephone or avoids the use of U.S. Mail.
Is unusually familiar with the workers’ compensation system or terminology.