Worker’s Compensation Fraud Investigation in New York

Protect Your Business from Workers’ Compensation Fraud

Workers’ Compensation is a program specially designed to protect the financial well-being of employees who are injured on the job. However, if a worker’s comp claim appears fraudulent, it can often be difficult to investigate the case without significant strain on your company as well as its owners and/or management.

Workers’ compensation fraud poses a significant threat to businesses, leading to increased insurance premiums, legal complications, and diminished workplace morale.

That is why we are here! At American Eagle Investigations, we are experienced Workers’ Compensation fraud investigators who conduct thorough investigations for insurance companies, claims adjusters, employers, third party administrators, and self-insurers. We specialize in identifying and addressing fraudulent claims, ensuring that your company’s resources are protected.

Understanding Workers’ Compensation Fraud

Workers’ compensation fraud occurs when an individual deliberately misrepresents an injury or illness to obtain benefits they are not entitled to. Common indicators include:

• Inconsistent Injury Reports: Discrepancies between the reported injury and medical evaluations.
• Delayed Reporting: Claims filed days or weeks after the alleged incident without a valid reason.
• Witness Absence: No colleagues or supervisors can confirm the occurrence of the reported incident.
• Physical Activity: The claimant is observed engaging in activities that contradict their reported limitations.

How A Private Investigator Can Assist With Worker’s Compensation Fraud Investigations

When trying to prove worker’s comp fraud, evidence is key. By hiring a private investigator near you to look into a possibly fraudulent worker’s compensation claim, you can discreetly collect the evidence you need.

What We Look For In Fraudulent Worker’s Comp Claims:

• Observation of Daily Activities/Surveillance: We will document activities that contradict the claimed injury, like lifting heavy objects or playing sports, and capture video evidence that may contradict their claims.
• Background Checks: Thorough investigations into the claimant’s history to identify any patterns of fraudulent behavior.
• Interviews: Conducting interviews with colleagues, supervisors, and other relevant parties to gather additional information.
• Medical Record Analysis: Reviewing medical documentation to identify inconsistencies or exaggerations in reported injuries.

This type of surveillance typically lasts a few days to capture a realistic view of the subject’s activities. Once our surveillance is complete, we share our findings with the client, who then works with their attorney or insurance provider to handle the legal aspects.

We Can Help With Your Struggle

As your private investigators, we understand that our clients’ needs are different depending on whether you are investigating fraud, subrogation, or for “Arising Out of Employment or in the Course of Employment” (AOE/COE) purposes. We approach all of our assignments with the expectation that the results may be presented in a court of law or before the New York Workers’ Compensation Board. Therefore, we understand the importance of a thorough, professional investigation.

In many cases, we will conduct covert surveillance with little more than a moment’s notice! We can arrange to observe a claimant prior to and following an Independent Medical Examination throughout New York and New Jersey. We will video record the suspected fraud activity as it occurs in a non-intrusive manner that protects even the suspect’s legal rights. We will also perform interviews relating to AOE/COE investigations, which is a critical phase of the claims process.

Your private investigators will gather the necessary evidence and provide the most professional report in the industry, along with remedies that may include both criminal and civil action, and present it to you as part of your legal counsel. Our clients frequently inform us that they appreciate the continuity we provide on cases, which are periodically reviewed over the course of many years.

For more information on our Workers’ Compensation investigations, please call American Eagle Investigations at 212-344-8997 or fill out our online contact form.

Also see our page on personal injury accident investigations if you have suffered an injury due to someone else’s negligence.

Learn More About Protecting Yourself and Worker’s Compensation Fraud