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Workers Compensation Fraud

Private Investigator Stryker PI | (800) 733-1950

Stryker conducts Workers Compensation Fraud investigations on behalf of insurance carriers, third party administrators, law firms, municipalities and employers from the private sector. We concentrate our knowledge, skills and expertise on a specific type of products and investigative services that encompasses all aspects of Workers Compensation Fraud Insurance Investigations – Insurance Defense, deceptive practices, pre and post-litigation support. Consequently, our focused performance will bring our clients exceptional work product and unparalleled service results.

Contrary to what most people believe, workers’ compensation fraud is more that just an employee exaggerating his medical condition or working for cash while supposedly disabled. While these things do occur, employers are also committing fraud by underreporting their payrolls to receive lower premiums and health care providers are billing for services they’ve never performed. Workers Compensation Fraud is costing the industry and citizens of our state billions of dollars each year.

But what is workers’ compensation fraud? Workers’ compensation fraud occurs when someone willfully makes a false statement or conceals information in order to receive workers’ compensation benefits or prevents someone from receiving benefits to which they might be entitled. Below are a just few examples of how workers’ compensation fraud can be committed.


THE COST OF FRAUD


The insurance industry consists of more than 7,000 companies that collect over $1 trillion in premiums each year. The massive size of the industry contributes significantly to the cost of insurance fraud by providing more opportunities and bigger incentives for committing illegal activities. The total cost of insurance fraud (non-health insurance) is estimated to be more than $40 billion per year. That means Insurance Fraud costs the average U.S. family between $400 and $700 per year in the form of increased premiums. FBI Publications


INVESTIGATION TACTICS 

  • Surveillance – Investigators may use audio, video, and other types of surveillance to determine whether an individual worker is as injured as they claim.
  • Document Review and VerificationConduct a Social Security number verification. The IRCA prohibits an alien from using “any document lawfully issued … to a person other than the possessor” to get a job.
  • Interviews and research – Workers compensation investigators may interview colleagues, friends, family, and other individuals to learn whether there is an issue of fraud and, if so, how great.
  • Background checks and records research – An investigation into worker’s compensation fraud may include checking medical records, employment records, and other records. Private investigators may also run background checks to see whether a worker has filed numerous compensation claims in the past or if the company has a history of misclassifying employees.
  • Evidence gathering – Workers compensation investigators can gather evidence if they uncover workers compensation insurance fraud. This can help employers and businesses prosecute fraud and cut off workers compensation claims that are not legitimate.