Suspicious Claim

suspicious25-30% of workers’ compensation claims involve some level of fraud. These indicators, or “Red Flags”, should help isolate those claims warranting closer examination.

SRG specializes in obtaining the crucial evidence in identifying a malingerer and fighting a fraudulent claim. Utilizing highly trained investigators and state-of-the-art surveillance equipment SRG has a proven track record on capturing videotape footage that will challenge the allegations of disability.

Indicators of Workers’ Compensation Fraud – RED FLAGS –

  • Injury occurs on late Friday afternoon or Monday morning
  • Injury occurs immediately before a possible termination or layoff
  • Claimant has suspicious medical providers or legal consultants
  • There are no witnesses to the injury
  • There are conflicting descriptions of the injury as compared to the original injury report
  • The claimant has a history of claims
  • Claimant protests about returning to work and never seems to improve
  • Claimants attorney becomes involved early in the claims process
  • The claimant refuses treatment
  • The claimant has a criminal record
  • The claimant is difficult to reach (Uses a P.O. Box, voice mail, mail drops)
  • Groups of claimants using the same doctors and lawyers
  • Late reporting of a claim without explanation
  • The claimant has a history of frequently changing doctors, addresses, phone numbers, or employment
  • Claimant undergoes extensive or unnecessary treatment for minor, subjective injuries