WORKERS’ COMPENSATION INVESTIGATION
WORKERS’ COMP INVESTIGATION
We provide our clientele with workers comp investigation services for insurance fraud focused on suspicious claims, statements, social media investigations, as well as, other insurance-related investigation requests. As such, our focused performance will bring our clients exceptional work products and unparalleled service results for insurance companies, municipalities, third-party administrators (“TPA”) law firms, their attorneys, and private clients to help mitigate the loss and exposure on even the toughest claims.
We provide multi-line insurance investigations that are battle-tested insurance defense services. These services include Workers’ Compensation Subrosa surveillance and 4-hour activity checks, home care, hospice caregiver integrity investigations, employer level accident investigation AOE/COE statements from the Claimant and witnesses, and third-party subrogation and identify property owners, individuals, responsible parties, or entities involved, and fraud investigation focused on suspicious claims, surveillance; as well as, other insurance-related investigation requests. We provide insurance defense services to insurance carriers, third-party administrators, law firms, municipalities, and employers from the private sector. We recognize fraud occurs in simple and complex schemes of intentional misrepresentation or concealment. Unlike errors or mistakes, fraud is deliberate and maybe intentionally hidden. For this reason, we use creative strategies to determine the presence of deception, which is intended to achieve financial or personal gain at the expense of a victim. Every investigation is unique, and there is no one-size-fits-all approach. We work directly with the examiners, attorneys, and management to conduct the services around a key or significant claim activity. Each insurance investigation is tailored towards the unique needs of a particular client and designed on a case-by-case basis to uncover the nature and extent of the deception and expose fraudulent and/or abusive claims.
- INVESTIGATION FORMS PAGE
- INSURANCE INVESTIGATION FORM
- GENERAL INVESTIGATION FORM
-
-
WORKERS’ COMPENSATION INVESTIGATIONS
Workers’ Comp Investigation: Stryker Investigations insurance defense services encompass all aspects of Workers’ Comp Surveillance, a 4-hour activity check using High Definition (HD) video cameras. Workers’ Comp surveillance is by far the most effective tool insurance companies use to mitigate the loss and exposure on even the toughest claims. Surveillance is one of the most common methods that private investigators use to document evidence on the Claimant’s level of activity and range of motion. A physical will review the surveillance video and determine if the Claimant is operating out of their prescribed restrictions.
When an investigator is able to capture video evidence of the claimant performing activities outside the scope of their physical restrictions set by their physician, the subject matter must be reviewed by their doctor. If the activities are, in fact, deemed outside the scope of their prescribed physical restrictions, the video may provide evidence that weakens or even stops payments of the workers’ compensation benefits. Stryker has the ability and equipment to capture video, both covertly from a vehicle and in person, with concealed cameras, and when appropriate, in rural communities, we can deploy drones to monitor a subject’s departure.
When it comes to fraudulent workers’ compensation claims, claimants use a myriad of methods to exaggerate and file false claims. These claims end up costing money and a loss of productivity for the employer, which, unfortunately, is passed on to the consumer. Fraudulent Workers’ Compensation claims cost everyone…
Investigators, adjusters, and employers working together can only recognize and react to the red flags that point to fraudulent Workers’ Compensation claims. A team approach to detecting and resisting fraudulent claims has been proven to be the most effective response in combating schemes to defraud insurers. Stryker PI, as the lead investigation agency, can conduct a comprehensive investigation and uncover the nature and extent of the deception and expose fraudulent and/or abusive claims. Once the investigation is started conducting Workers’ Compensation Surveillance at regular intervals will provide proof of a pattern of practice and provides a clear, precise, and comprehensive account of their actions. And allows motive to be proven in order to make plausible assertions about the claimant’s reasons for committing insurance fraud.
As a final point, Stryker concentrates our knowledge, skills, and expertise on a specific type of insurance investigation defense program that has been honed over the last two decades, as such, our focused performance will bring our clients exceptional work product and unparalleled service results.
Social Media Investigations
The benefit of using social media investigations to locate evidence of a subject’s physical activity and risk assessment for legal proceedings are limitless. During the last several years, insurance companies have increasingly relied on social media to investigate policyholders, as it can provide opportunities to uncover information that may conflict with or contradict information presented in your disability claim. Social media investigations are commonly used during court cases to provide information relevant to a case, supplement evidence, establish character, support, or disqualify an alibi. Social media is being used more and more in custody cases, divorces, and even criminal trials.
Call Stryker for additional insurance-related services