Workman’s Compensation Fraud
We are unable to get away from the fact that fraud occurs every day and the most common places it exists is workers comp and other insurance fraud. Apart from the billions, it costs each year (these losses are paid for by the contributors) there can be lives and livelihoods at risk.
Although it will be the company that is liable, they are never the real victims. The real victims are the people of all ages, all income brackets, and all races. These are the ones who are ultimately affected by this type of fraud.
If you suspect anyone is committing any fraud of this nature? We have experts in fraud issues who can help expose these individuals, so, any false claims will be denied and justice can finally be served. Although law enforcement agencies can be approached in these types of insurance fraud, they will not receive full attention.
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Who Commits Fraud?
Private Investigators of Las Vegas can fill the gap and provide speedier results. Over the many years of our expert fraud investigators covering cases of this nature, we have found it is not just regular people who are committing fraud.
Workers compensation fraud can be broken down into three distinct sections. You can quickly see it is not only regular workers who try and take advantage. Regardless of who is committing this fraud, our skilled Las Vegas fraud investigators will get to the bottom of the problem, and provide you with the results you seek.
Three Types of Fraud are as follows:
Fraud by the Claimant
- Exaggerating their symptoms for higher payouts
- Working while off on disability without reporting their second income
- Claiming against a work-related injury which never happened
- Claiming for an injury at work that was non-work related
Fraud by the Employer
- Over deducting contributions from employees’ wages
- Under-reporting a payroll or not classifying an employee correctly to gain lower insurance premiums
- The employer does not have the necessary worker’s compensation coverage in place
Health Care Provider or Medical Fraud
- False billing of treatments or services that were never performed
- Performing testing or treatment of injured employees to gain extra financial benefits
- Billing the worker’s compensation insurance company and the worker’s health insurance company for the same service or procedure
Bogus Lawsuits happen where a cooked health provider works with a lawyer who convinces employee’s to play along with their charade. The health provider gives the lawyers false information to back up their suing of an insurance company. In many cases, the company pays rather than facing an expensive lawsuit.
Who Loses with Fraud?
As a professional company who has served many individuals and businesses in Las Vegas in fraud cases, our fraud investigators have seen how this can affect the very people it is there to protect. To us it does not matter if it is an individual, employer or a shady health provider who is committing workman's comp fraud, our aim is the same as yours and to help prevent the following:
- Individuals lose their savings – trusting individuals pay premiums which are filtered
- Health risks – suspect clinic or healthcare providers can claim without diagnosing an actual injury
- Premiums – as a result of fraud, insurers or compensation funds increase the premiums to offset their losses
- Businesses lose out – an honest business can lose money because of workman’s compensation fraud as their coverage for employee health keeps rising
- Job loss – in a worst case scenario an insurance company or workman's compensation provider could go bankrupt if the level of fraud were high enough and for long enough. This can leave many individuals without health coverage
How We Perform Fraud Investigations
Many of these investigations begin with an initial consultation which is carried out with full discretion. Our expert investigators will use all of their skills and surveillance equipment to find any workers compensation abuse in alleged injured employees. This can involve video surveillance to make sure they are acting within any medical providers restrictions.
If the root of the fraud is from the employee or the health provider, different means would be required. You will be safe in the knowledge that our investigators will get the results while protecting you from any exposure.
As police resources are stretched, and a response can take time, we have been hired by not only individuals but also insurance companies who have time-critical fraud investigations that they need resolving.
As a professional company we make sure the right results and the best results are found the first time and as quickly as possible. This type of fraud affects too many people who are innocent and have no idea they are a victim until it is too late.
“I had an idea, the clinic my injured workers were visiting was giving too much time off work, and Private Investigators of Las Vegas found the doctor was skimming off the top by submitting higher claims against minor injuries.”
H W Bangor