A fraud investigator recognizes that workers compensation fraud is the most significant controllable cost factor in work force budgets today. Widespread misuse of workers compensation drives up costs, deflates productivity and destroys staff morale.
The most crucial factor in defeating workers compensation fraud is effective use of video surveillance to refute injury limitation claims alleged by the claimant. A picture tells a thousand words and is the key factor when we deliver top quality video which clearly shows that the claimant is exaggerating or falsifying the existence or extent of an injury.
We can assist law firms and insurance companies that are involved in workers compensation claims to conduct surveillance on possible fraud and abuse.
A red flag is a warning or a sense that something isn’t right with a claim and should lead one to take a closer look. The lists below will help employers and claims professionals know what to look for when identifying possible fraudulent behaviors. Identification of any one of the following red flags does not mean that fraud exists, but these and others may be contributing factors.
Red flag indicators that may signal fraudulent activity include
- Number of days worked and amount of salary inconsistent with occupation
- Injured worker disputes average weekly wage due to additional income (i.e., per diem and/or 1099 income)
- Cross-outs, white-outs and erasures on documents
- Injured worker files for benefits in a state other than principle location of the alleged industrial injury or occupational disease
- Injured worker-listed occupation is inconsistent with employer’s stated business
- Injured worker address is different than principle location of employer other than border states
- Injured worker cannot be reached because he or she is never home or is reportedly sleeping and cannot be disturbed
- Injured worker is seen with calluses on hands, grease under fingernails
- Injured worker moves out of state or country shortly after filing claim
- Accident/incident occurs immediately prior to strike, layoff, plant closing, job termination or job completion
- Injured worker is in line for early retirement;
- Injured worker refuses (or delays multiple times) diagnostic procedures to confirm injury
- Conflicting descriptions of the accident/incident between employer’s report and initial medical evaluation
- Injury is not consistent with nature of business
- Date, time and place of accident is unknown
- Injured worker cannot recall specific details about the injury
- Report of injury not timely and immediate
- No witnesses to accident
- Tips from coworkers.
Short Term and Long Term Disability
Disability fraud services are a high priority in today's age. To combat disability fraud we conduct thorough surveillance and background research to stop losses from this fraudulent activity.
Whether the subject is collecting disability for a short time or several years our main focus on conducting surveillance operations on subjects is to verify their daily activities and movements on any given day.
For a FREE Consultation or more information give us a call at 732-320-7241 or fill out our short form Contact Us
Morrell Investigations & Services | P.O. Box 2180, Red Bank, NJ 07701 | 732-320-7241 | firstname.lastname@example.org
New Jersey License #8819
New Jersey License #8819