Most employers agree that disability insurance and worker’s compensation insurance are sensible insurance programs. These programs are designed to protect the employee and the employer. Not only are these insurances required by law, but they furnish necessary protection for the employee. Some companies require a minimal employee contribution for disability. Worker’s Compensation Insurance is required by state and federal law and is the responsibility of the employer.
When it comes to these forms of insurance, employers, insurance companies and Private Investigators, from New Hampshire to Massachusetts and beyond, have seen it all. Employees without health insurance or who have pre-existing conditions or who seek an easy way out, abuse the worker’s compensation coverage. Employees, who have personal issues and know they do not qualify for unemployment insurance benefits, find ways to manipulate disability insurance. Much insurance fraud is committed by repeat offenders who may well know more about their rights and the workings of the system than the employer.
Fraudulent worker’s compensation claims and fraudulent conduct regarding disability insurance cost companies money and contribute to higher than necessary insurance premiums. Additionally, word of fraudulent insurance manipulation spreads through a company quickly and can have very negative effects on employee morale.
It is the employer’s responsibility to manage and validate fraudulent insurance claims. Private Investigators have many options to identify and verify claims.
Background checks, interviews with connected persons, video surveillance and photo surveillance are all useful in ascertaining the validity of claims. Many times employees claim insurance and then go about working “off the books” for alternative income. Another common abuse is to extend the payments beyond the actual recovery date.
Employers provide these insurances with good intentions. Most employees would never abuse the coverage. However, especially in today’s economy, desperate employees resort to desperate measures.
When an employer suspects irregularities, a Private Investigator should be contacted. Communication with the investigator should be confidential. Employers should resist the temptation to handle the matter internally or by direct contact. The wrong move can have serious repercussions within the company and from the employee.
Employers should be prepared to give the Private Investigator access to the employee’s file, including name, address, date of birth, social security number and any other pertinent information. Most Private Investigators are qualified to testify before the Worker’s Compensation Board or in disability review boards. This testimony may be necessary.
Failure to act on insurance abuse sends a negative message to other employees. Companies should be prepared to defend themselves. The retention of a qualified Private Investigator can help uncover insurance abuse and keep insurance premiums at a fair rate
