USING SURVEILLANCE TO STOP WORKERS COMPENSATION FRAUD
Surveillance is costly and time-consuming. The expense of a private investigator (PI) to prove workers compensation injury by the claimant is not actual or fabricated, ranges through $75 to $175 an hour, based on the venue and the state’s legal criteria to become a private investigator. Surveillance expenses will increase exponentially as the private investigator watches and prepares for the claimant to step out of his apartment or depart and travel away from the claimant’s apartment all day long. Stopping a fraudulent claim with surveillance demands that the surveillance is implemented properly and in the appropriate scenario. Below are the most suitable ways to utilize surveillance:
- When the employee says that he is so seriously hurt and he can’t do anything.
- If there’s good evidence to suggest that the injury claims aren’t as specified.
- The person is employed somewhere, and it is discovered.
- When the claim holds the capacity to cause disaster.
- When there is a necessity to avoid a claim that is fraudulent, and all the colleagues know.
An employee suffered a verifiable injury, but the reported results appear out of comparison to credible clinical facts.
The worker, for example, stumbled and got her knee bruised. The next thing the worker does is treat her face, upper back, lower back, all legs, nausea and fibromyalgia, and fractures. The worker informs the healthcare provider that she is so seriously injured that she can barely walk, and any attempt to move causes extreme discomfort. Surveillance footage of the employee going around the store with several heavy items will refute the subjective complaints of the worker, but that does not typically contribute to her rapid healing process. One thing that wise adjusters realize about surveillance is typical that they require more than one day of footage to counteract the claims of the worker being captured on camera.
If the worker is severely hurt and can be identified as a complete lifelong disabled person, testing can be used to verify the worker’s limitations. Sometimes the surveillance can show that the worker is unlikely to be able to move without a stick or is unable to lean to get into his vehicle or needs to be helped in ascending stairs. In this case, surveillance will validate taking the claim to quicker resolution depending on the employee’s confirmed physical limits. Occasionally the surveillance would reveal that the claimant had misled the physicians, and the severity of the damage is not quite as severe as the individual had described. Although the chances are against the success of the Private Investigator, whether the Private Investigator shows that the worker is not severely hurt, then the injuries do not restrict the claimant because the expense benefit on the claim can be considerable. Surveillance may be employed to determine that the assertion is completely untrue.
Adequate evidence to sue the contractor for fraud could be obtained by surveillance. If the company suppresses fraudulent activities, the amount of fraudulent reports decreases steadily to close to nothing. Surveillance may decrease the possibility of fraudulent claims if implemented properly. Any time you think a claim is fraudulent or you feel that surveillance can show a claim to be fraudulent, call the compensation adjuster for your employees to address if you think surveillance is required. Sometimes, you’ll be right.