Workers’ compensation is an insurance program that is designed to assist employees who become injured on the job or suffer a job-related illness. Unfortunately, not every claim that is filed is legitimate and the business is often the one that pays the price. In fact, more than 1 in 10 employers are concerned that a worker will fake an illness or injury in order to fraudulently collect workers’ comp benefits. Let’s take a closer look at the different types of workers’ comp fraud and what you can do to protect your company from becoming a victim.
Types of Workers’ Comp Fraud
False Claim – This occurs when an employee is never injured at all, but claims he or she was on the job in order to collect insurance payments. In some cases, a worker may actually go to the extent of injuring him or herself (usually by staging an accident) to bolster their claim.
Working While Collecting – Another costly form of workers’ comp fraud occurs when someone who may or may not be legitimately injured and is subsequently collecting benefits stating he or she is unable to work, but is actually working elsewhere at another job.
Exaggerated Claim – These are cases in which an employee legitimately sustained an injury, but is exaggerating its severity in order to extend the amount of time off and benefits he or she can collect.
Employer Fraud – In some cases, the business itself may be engaging in behavior that is classified as workers’ comp fraud. This is typically done through employee misclassification. In other words, a company will erroneously list a full time worker as a contractor to avoid having to pay higher premiums.
Not sure which, if any, of these types of workers’ comp fraud are occurring? Here are 10 warning signs to watch for.
How a Private Investigator Can Help
If a business suspects that one or more employees are engaging in workers’ comp fraud activities, it can be wise to enlist the help of an experienced private investigator. This professional can then do the following in order to identify areas of legitimate fraud and also build a case against the offender:
Gather evidence. This may include conducting surveillance of the employee in question and capturing evidence of dishonesty. For example, the investigator may take video or pictures of the offender working at another company on the side or engaging in physical activity that is not consistent with the supposed injury or illness.
Conduct background investigation. In many cases, a person who commits workers’ comp fraud has a long history of similar claims. A thorough background investigation can reveal patterns that may raise suspicion and concern and can also help build a stronger case against the offender.
Documentation. Once all of the necessary evidence is collected and a detailed background check has been performed, the final step in the workers’ comp fraud investigation will be compiling all the documentation needed to pursue the case.
Could workers’ comp fraud be costing your business money? Don’t take chances. Trust the experienced team at Lauth Investigations International, Inc. to handle your case swiftly and efficiently. We can help you get the evidence you need to mitigate your damages and avoid becoming a victim again in the future. Call us today to learn more.