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Investigating workers’ compensation fraud

Oklahoma residents may be surprised to learn that workers’ compensation fraud is thought to cost the U.S. economy more than $7 billion every year. Insurance companies examine workers’ compensation claims closely, and they generally look for warning signs such as claimants with a long history of claims, injuries that go unreported for days, a lack of witnesses to the accident or incident in question and conflicting reports of what transpired. However, there are steps that insurance companies may take that go beyond merely reviewing paperwork.

Using investigators is often the last resort when insurance companies feel that workplace injuries are being fabricated or exaggerated. While video footage of a purportedly incapacitated worker enjoying vigorous leisure activities or performing grueling household chores may be extremely persuasive, it often comes at a very high price. Following a workers’ compensation claimant unnoticed for prolonged periods could require a team of investigators, and the operation could drag on for days or even weeks before suitably incriminating evidence is produced.

Companies hoping to save on investigation costs have begun to focus their efforts on the virtual rather than the physical footsteps of claimants. Images posted on social media platforms like Facebook and Instagram can be just as damning as video footage recorded surreptitiously, and claimants may find it harder to deny the validity of evidence when they have created it themselves.

Legitimately injured workers may also be victims of workers’ compensation fraud as insurance companies grow ever more vigilant and cautious. Attorneys with workers’ compensation experience may be familiar with the indications of fraud that insurance companies are usually sensitive to, and they could recommend that proactive steps be taken to clear up any ambiguity and substantiate the injured or sick worker’s account of events.


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