How to Identify Workers’ Comp Fraud

Orange County workers comp fraud investigatorsWorkers’ compensation fraud is, sadly, an all-too common problem for businesses of all types, accounting for a quarter of all insurance fraud. If an employee has recently filed a workers’ compensation claim that strikes you as suspicious, ask yourself these questions:

  • Were there witnesses to the accident? With no witnesses and no surveillance footage, it’s possible for an employee to falsify or exaggerate an accident.
  • Has it happened before? Is your employee just unlucky… Or is their newest accident one of a string of paid vacation ploys?
  • When did it happen? Accidents that are reported late on Friday or early on Monday may warrant more scrutiny. That goes double for accidents reported after an employee has been terminated!
  • Is the employee behaving suspiciously? Failure to attend follow-up appointments, physical therapy, etc. could indicate that the employee is not actually injured or that they trumped up the extent of their injuries.
  • What are you hearing through the grape vine? Don’t discount the notorious rumor mill! If you hear that an employee is holding down a job somewhere else, hitting the golf course, or otherwise indicating that they’re not actually unable to work, it’s well worth the effort to hire a private investigator.

Even if you just have a sneaking suspicion that a workers’ comp fraud is fraudulent, trust your gut. Don’t say anything to the employee, just call Systematic Inquiry Group. Our Orange County private investigation firm specializes in workers’ comp investigations. We can help you catch the guilty party in the act, as we’ve done for countless other clients in Orange County and beyond. Photo by Ambro via

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