• Workers' compensation, general liability, accident and all related insurance fraud investigations.
• Criminal and civil investigations - legal counsel support services.
• Maximize the success of your case by viewing our >> Client Advisory Sheet first

Insurance Claimant - June 29, 2004	Proof of Fraud - August 27, 2004

Reports

• Includes photographs extracted from videotape exhibits
• Professional, concise, prompt
• E-mail, verbal and/or written progress reports followed by detailed, court-presentation quality reports
• Interview and statement recovery
• Activity check investigations

Research

• In-depth background research and vetting
• Trace & verification of subject data
• DMV, Criminal & Civil litigation research

Equipment

• Fully equipped surveillance vehicles
• State of the art video equipment - digital and analog – enhanced communication facilities

 

Employee, leaving residence and placing cane against wall to accommodate closing jacket.	Employee, coat not closed, cane retrieved and commencing to run to catch up with persons proceeding in advance.	Employee in full flight.

Close-up of employee running absent use of the cane.	Employee running, legs bent use of cane entirely cosmetic.

Workmen's Compensation

Red Flags That May Help to Identify Potential Insurance Fraud

Flag 1: Claimant is never home to answer the phone or is "sleeping and cannot be disturbed."

• Keep track of your telephone calls, date, day of the week, and exact time.
• Record "Who" answered phone?
• Record "What" they say, exactly?
• Record "What" time was claimant expected back, or to be "awake"?

Flag 2: Injury coincides with:

• Anticipated layoffs or plant closing.
• Monday morning occurrence
• No witnesses

Flag 3: Leads from co-workers suggest that your subject is active in sorts or other activities.

• What did they see or hear, exactly?
• When and where did they see the claimant?
• Can witness be questioned in more detail?

Flag 4: Rehab reports indicate a healthy-looking claimant

• Have rehab nurse supply detailed description of claimant.
• What type of car was claimant driving or a passenger?
• Get photograph of claimant from rehab nurse.

Flag 5: No organic basis for disability. All indications are that the subject has made a full recovery.

• Request Activity check or Surveillance to determine activity level.

Flag 6: Claimant receives mail at a post office box and will not divulge the actual address of his/her
residence.

• Are there any other addresses listed in the file?
• Get a telephone number for the claimant at his residence.

Flag 7: Claimant has a history of self-employment as a tradesman (carpenter, electrician) who might readily work for cash while collecting disability.

• What was claimant's occupation?
• Any history of self-employment?

Flag 8: Claimant has moved out of state or country.

• Request Activity check or Surveillance

Flag 9: Excessive demands for compensation.

• Request Activity check or Surveillance

Flag 10: Disability beyond that normally associated with claimed injury.

• Request Activity check or Surveillance

Flag 11: Claimant has a history of malingering.

• Request Activity check or Surveillance

Flag 12: "Dueling Doctors" One says the claimant is disabled, the other says no.

• Request Activity check or Surveillance

Most Workmen's Compensation claims normally fall into one of the following categories:

1. Actual injury while on the job
2. Actual injury that occurred outside of work
3. Exaggeration of injury
4. Malingerer
5. Planned Fraud

   a No work income
   b Additional income

   c Anticipation of lay-offs

   d Home care - babysitting

   e Early retirement