Reasons to Hire A Private Investigator For Insurance Fraud Investigations   

Suspecting a workers’ compensation fraud? A specialized legal professional at Affirm Investigations can help you in more than one way. Learn how below.

Every year, insurance fraud costs the US a whopping $30 billion – and workers’ compensation insurance fraud cases represent an always-growing contributor to this burden. But for small businesses, local organizations, and startups with a bright future ahead, a workers’ compensation fraud can cause much more than just financial damages.

Indeed, insurance fraudulent behavior can compromise a company’s reputation and compromise its ability to attract top talents, work with reputable suppliers, and be respected by its audience.

So, if you are suspecting fraudulent behavior that might lead to worker’s compensation insurance fraud, you should not think twice about working with a professional. Here are just some of the reasons why you should hire an investigator at Affirm Investigations.

Workers’ Compensation Fraud: An Overview

Worker’s compensation is something that all businesses should invest in – even in those states where this is not a legal requirement! Indeed, just in 2020, the US private sector reported nearly 5,000 fatal injuries and over 2.7 million nonfatal injuries.

Without worker’s compensation insurance, the company will be required to cover medical bills and costs associated with their employee’s on-the-job injuries out-of-pocket.

There are several types of worker’s compensation fraud, including:

  • Worker fraud – in most states (including Wyoming and Colorado) worker’s comp is a no-fault system, meaning that the employee does not have to prove that the injury was due to someone else’s negligence to claim coverage. Common employee fraud includes false claims, falsified or inflated medical bills, and withheld information.
  • Employee fraud – employees are required to have worker’s comp in most states, but this is not federal law. Fraud can happen if an employee fails to take out a worker’s comp insurance and then lies about it, overstates wages, prevents an employee from getting their benefits, or wrongly categorizes an employee’s status to pay a lower premium.

Other types of worker’s comp insurance fraud include medical provider fraud and conspiracy between employers and employees to obtain insurance payments.

Why You Need a Private Investigator for your Workers’ Comp Insurance Fraud Case

Worker’s compensation insurance frauds are extremely complex cases. And, if you suspect that fraudulent behavior is underway in your place of work, you should not think twice about hiring a specialized investigator. Here’s why.

Curbing Fraudulent Behavior At The Start

If you have been suspecting fraudulent behavior from your healthcare provider, employer, or employee, there is no time to lose. Indeed, bad actors can easily carry out their deceit within days! So, you’ll only have a short window of time to gather all the evidence you need, get answers to your questions, and expose wrongdoing.

A private investigator at Affirm Investigations can help you quickly discover the truth and collect evidence that is both concrete and indisputable – which is essential if you wish to unearth the fraud and bring your case to court!

Insurance Fraud Often Requires Surveillance

Since worker’s compensation is a no-fault system in both Colorado and Wyoming, insurance companies will not carry out substantial investigations into the dynamics of a work-related accident.

However, this makes it even more important for a business to understand whether the claim is truthful or fraudulent. And, to do so, you’ll almost always need professional surveillance systems – such as drones, cameras, and tracking.

This is essential to understand if the claimant is genuinely entitled to receive insurance benefits and bring to light any suspicious activity involving employees, employers, or healthcare providers.

Working with a licensed PI allows you to collect the evidence you need without breaking privacy laws and carry out surveillance of a subject with discretion.

An Investigator Can Help You Track Bad Actors

If your employee or employer is a bad actor in a false insurance claim, working with an investigator allows you to track their whereabouts. There are multiple reasons why you should consider the benefits of this service, including:

  • An employee might inflate their reports of injuries suffered in a work-related accident in an attempt to obtain a larger monetary compensation. A tracking system allows you to know whether they are where they say to be – i.e.: in the hospital or bedridden
  • Employees, employers, and medical providers might be collaborating with an intent to defraud a third party or insurance company. Tracking a suspect can help you provide evidence of their relationship with other parties.

A specialized PI will be able to advise you regarding the best strategies to use to provide evidence to build your case.

Investigators Help You Produce Evidence

Private investigators offer a wide range of services to their clients. When working with a dedicated PI, you will be able to design a tailored strategy to find all the evidence you need to unearth an insurance fraud case and build your case in court.

Some of the evidence needed include photos, videos, reports, and details of the accident. It is also important to ensure that the evidence provided cannot be invalidated.

Thanks to their experience in the field and licenses, PIs are important partners to have by your side when trying to prove that fraudulent actions are taking place.

Insurance Fraud Investigators Know How To Help You Build Your Case

If you are determined to obtain justice for your case and unearth dishonest behavior, you will need to produce concrete evidence of the schemes that your medical provider, employer, or employee is carrying out.

Working with a PI not only allows you to collect the information and evidence necessary to build your case but it can also help you organize the evidence collected in a logical way. This is essential to strengthen your case, press charges, and protect your reputation and financial health.

Carrying Professional Background Checks to Prevent Workman’s Compensation Fraud

If you are a business owner, manager, or HR professional, you know the importance of hiring the right talents for your business. So, while it is important to ensure that a new hire has the skills and abilities to become a valuable team member, it is also important to ensure they align with the company’s values and interests.

Private investigators can help you carry out background checks on your prospective employees to ensure that they don’t have a history of fraudulent behavior.

Working With a Specialist At Affirm Investigations

At Affirm Investigations, we have years of experience in helping businesses and individuals protect themselves and their loved ones from insurance fraud claims. Are you suspecting fraudulent activity within your company or against you?

Partner with a specialized PI at Affirm Investigations to get all of your questions answered and unearth an insurance fraud case today. 

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