Uncovering Workers Comp Fraud Through Surveillance

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Uncovering Workers Comp Fraud Through Surveillance

Most business owners want to believe that they have assembled the most trustworthy and respectable team possible, but unfortunately, there are often a few employees who will jeopardize that trust for everyone. One of the ways that individuals will do this is through fraudulent workers compensation claims.

When even one staff member files a false claim, this hurts the company as a whole, and can negatively affect both the profits of the business and the wages and benefits of the rest of the employees. Having proper surveillance in place is beneficial to the entire organization.

Understanding Workers Compensation Fraud

When used correctly, the workers comp system is a necessary and upstanding program. It holds the company accountable for injuries that employees sustain while on the job. The injuries will be obtained due to accidents that occur while the individual is working for the business. In most cases, the injured employee will receive a portion of their normal wages to make up for the time that they are recuperating and physically unable to work.

Unfortunately, people will occasionally abuse this program. Workers comp fraud occurs when an individual exaggerates the nature of the injury, or completely fabricates a false story regarding being injured at work. The result is a company that is compensating for harm that they have not truly caused. The complexity of the fraud will vary from case to case and will sometimes require very lengthy investigations and a lot of documentation.

The advantage of consistently maintaining lawful surveillance is that employers can identify not only instances of workers compensation fraud, but other problems as well. Evidence could be documented that pertains to other forms of insurance fraud, employee theft, or other types of unethical behaviors. By having legal forms of surveillance in place, business owners can identify and address serious issues before they are able to become extremely costly problems for the company.

Gathering the Evidence Necessary to Prove Workers Comp Fraud

In order for a company to prove that fraud has been committed, they must have gathered very strong documentation to support their claims. Without clear and straightforward evidence, the courts are likely going to side with the employee, and the trial process will be a further waste of time and resources for the company. It is for this reason that businesses should utilize lawful surveillance techniques.

For the evidence to be admissible in court, it must be collected using legal methods. Lawful surveillance simply refers to surveillance that is conducted in areas where privacy is not implied or expected. Basically, the business has the right to install surveillance equipment in public places. Along with video surveillance, private investigators can also utilize photographic evidence and witness interviews and statements in order to build a strong case for the company.

Working With Experienced Private Investigators 

Even if there is clear video evidence that an employee has committed fraud, it is crucial to collect, prepare, and document this information very carefully. One small procedural misstep could cause the evidence to be inadmissible, and never be reviewed by a jury or judge. Experienced investigation professionals must handle every piece of information, including photographs and statements, very delicately.

This is why it is highly recommended that businesses hire third party private investigation agencies such as Prudential Associates that have vast experience with handling sensitive cases. It is ideal to work with investigators and specialists who have previously served with agencies such as the FBI or CIA. Business owners can typically look at an agency’s previous work and recommendations in order to understand if the investigators have the skills and expertise necessary.