Workers’ Compensation Investigations

Workers’ compensation fraud is a major problem, and it’s trickling down to affect those with legitimate work-related injuries. Because of selfish and dishonest people who try to game the system, it makes it more difficult for everyone else to get coverage, even those who really need it.

When someone deliberately lies to get more out of workers’ compensation benefits than those to which they’re entitled, a private investigator can be called in to establish the facts of the situation. Private eyes play a major role in workers’ compensation investigations and can help save insurers and companies millions in insurance losses.

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Fraud Isn’t Just Workers

Many people think that the only kind of workers’ comp fraud that exists is when a worker tries to game the system, but the truth is, employers can be involved in this kind of fraudulent activity as well. When an employer denies a valid claim, delays issuing checks, misclassifies employees to avoid having to pay out, deliberately refuses to carry required insurance, or creates hostile work environments in retaliation against those who file claims, this is also considered fraud.

Workers’ Compensation Investigations

A private detective called in to conduct workers’ compensation investigations can fulfill a broad variety of functions and gather a range of facts to explore the situation. They could look into the truth behind an injury report without witnesses, delays in the reporting of an injury or in seeking medical treatment, missing doctor’s appointments, or possibly suffered an accident outside of work.

Workers Compensation Investigations

On the employer end, they might research whether an employee is misclassified to avoid carrying insurance, whether “ghost policies” are carried, or if the employer is somehow otherwise trying to avoid providing legitimate workers’ compensation coverage.

In researching these issues, the investigator might look at whether an employee is suffering from undue financial stress outside of work, whether they’ve filed multiple claims, or have other reasons why they might be trying to get some extra money fast.

Techniques Used

As they research workers’ compensation fraud, a P.I. might engage in surveillance, using video, audio and even electronic methods to observe the degree of injury. They might conduct background checks and interview witnesses about the case at hand. They will use all the means available to gather evidence about a given case to determine whether a worker is trying to defraud an employer, or an employer is trying to illegally avoid payment.

Workers’ Comp Investigators

The goal of a workers’ comp investigator is to keep everyone honest. They protect employers, employees and insurance companies against misuse of the system, which costs millions of dollars in damages every year. It’s astounding, but 25% of Americans think it’s perfectly justifiable to engage in insurance fraud, but the truth is, every incident hurts thousands of people in terms of increased premiums and reduced access to coverage.

If you think helping to keep people honest, increase access and availability of insurance, and keep coverage costs down sounds like a great career, you might want to consider being a private detective specializing in insurance fraud. Check out what it takes to pursue this career path in your state.

Online Criminal Justice and Private Investigator Programs

Online Criminal Justice and Private Investigator Programs

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Choose your area of study and receive free information about programs you are interested in. Private investigators are used by law firms, law enforcement, insurance companies, as well as individuals to conduct investigations to build criminal and civil cases. A degree related to criminal justice could benefit an aspiring private investigator greatly. Request information from multiple schools to find the best program and educational opportunity for you!