Workers’ Compensation & Insurance Fraud

Workers’ compensation fraud is not just “someone filed a claim I don’t like.” A suspicious workers’ compensation claim and a fraudulent workers’ compensation claim are not the same thing. A claim can look exaggerated, poorly timed, inconsistent, or flat-out questionable without automatically being fraud. Fraud requires something more serious: intent. In plain English, workers’ compensation […]

A Private Investigator’s Day in Court Does Not Always Go According to Plan Private investigators do testify in court, but if you think it always looks clean, organized, and dramatic like it does on television, I hate to ruin the fantasy. Court is unpredictable. Sometimes the video comes in. Sometimes the report becomes the focus. […]

The Employer can hire a PI for their claims and they should! The Employer knows best Yes, an employer can hire a private investigator for a workers’ compensation investigation, and in many cases, they should. Don’t be swayed by your insurance adjuster who says no or their SIU team. The employer often has information nobody […]

Surveillance Alone Does Not Prove Fraud. Timing Does Workers’ compensation fraud is rarely exposed by luck. It is uncovered through timing, strategy, and a clear understanding of how questionable claimants behave once they realize they may be under scrutiny. In many cases, surveillance teams are sent out with a basic assignment: document activity and report […]

Workers’ compensation claims are meant to provide support for employees who are legitimately injured on the job. However, exaggerated or fraudulent claims can create significant costs for employers and insurance carriers. One effective way to identify inconsistencies is by conducting surveillance before a claimant’s deposition. Understanding the Role of Depositions in Workers’ Compensation Cases A […]

When a workplace injury occurs and a workers’ compensation claim is filed, both the employer and the insurance carrier often want to understand exactly how the incident happened. The initial report of injury is only the beginning of the investigation process. In many cases, the first step is obtaining a statement from the injured employee. […]

Workers’ compensation fraud is far more complicated than most employers realize. Unlike other forms of insurance fraud, workers’ compensation claims operate under rules that often favor accepting the claim first and investigating later. California is a no-fault workers’ compensation state. This means that if an employee reports an injury that occurred while performing their job […]

Recently, we were contacted by a mid-sized Southern California employer operating in both Orange County and Los Angeles. With approximately 350 employees providing overnight commercial cleaning services, this is the type of company most people never notice — yet rely on every morning when their offices are clean and ready for business. Over the past […]

What the Orange County Judge Case Exposes and What Small Businesses Need to Understand Most employers think workers’ compensation fraud looks like an employee faking a limp. That’s the easy stuff. The uncomfortable truth is that some of the most damaging fraud doesn’t come from claimants at all comes from inside the system that’s supposed […]

Employers, Don’t Wait On Your Insurance Adjusters! Insurance Fraud is On The Rise In the realm of workers’ comp fraud investigations, the prevalence of fraudulent claims necessitates the indispensable role of a private investigator. The significance of hiring a private investigator for workers’ comp fraud cases is astronomical. Know the steps involved in hiring one, […]