We all pay a price for worker’s comp fraud, but businesses shoulder the majority of the costs and responsibly.
Businesses pay higher worker’s comp premiums because insurers pass the high costs of fraud onto their policyholders. Often the premium increases are large and very damaging —especially for smaller businesses that can least afford higher premiums. Workers lose jobs because businesses often must reduce their workforce, move to another state, or even go bankrupt because of higher premiums.
Higher worker’s comp premiums depress a firm’s income, lower employee productivity, and force some companies to go out of business. Honest businesses also find it harder to compete against dishonest firms that lower costs by illegally avoiding worker’s comp premiums.
Companies need to be proactive in addressing and dealing with worker’s comp fraud. Hiring a private investigative firm to investigate claims can help companies’ lower premiums by preventing fraud at the source.
Contrary to what most people believe, workers’ comp fraud is more than just an employee exaggerating his medical condition or working for cash while supposedly disabled. Worker’s comp fraud cost companies millions of dollars each year in increased premiums and larger deductibles for companies to shoulder. Although companies turn to their insurance providers to verify claims, the insurance industry doesn’t generally contest claims under a certain monetary threshold.
Many businesses have started to hire private investigation firms to conduct surveillance on employees with suspicious claims in an attempt to manage insurance costs and combat fraudulent claims.
A good private investigator will conduct several rounds of surveillance on an individual who may be suspected of filing a fraudulent claim. The investigator will capture the suspect on film either violating the limits of his/her claim or verify the claim was legitimate. Film doesn’t lie and multiple instances of a suspect defrauding his/her company can help to prosecute the individual to the full extent of the law in court for insurance fraud.
Recently, my agency conducted worker’s comp surveillance for a proactive manufacturing company on an individual who had filed a claim after injuring his hands due to a workplace accident involving the company’s product. The individual’s claim was that due to the accident in the workplace he couldn’t use his hands to perform any aspect of his former position. The company was looking at insurance premiums skyrocketing and a million dollar settlement claim for the employee.
Upon beginning our surveillance, we discovered the suspect had opened a moving company and on several occasions we captured him moving sofas, beds, and other large furniture items. Our agents filmed him a total of four times lifting and carrying furniture in a manner he claimed he could no longer do thanks to the accident. Our surveillance led to the claim being rejected and the defrauder looking at serving jail time for his attempt to scheme the system.
I actively encourage our clients to prosecute all workers’ comp-related fraud cases with the district attorney and the insurance commission of the state. Everyone suffers because of workers’ compensation fraud. Tax dollars are wasted, the price of consumer goods increases, and employers and legitimately injured workers lose money.
Do you have questions about how you can deploy a private investigator to attempt to help cut down on possibly fraudulent worker’s comp claims? Please let me know and I would be pleased to address your concerns.