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“In California, workers' compensation insurance is a no-fault system. Injured employees need not prove an injury was someone else's fault in order to receive workers' compensation benefits for an on-the-job injury. In addition to medical expenses being covered for injured employees, some injured workers are entitled to recover a portion of lost wages resulting from injury. Fraudulent workers' compensation claims can be an enticing target for criminals.

 

Workers' compensation insurance fraud occurs in simple and complex schemes that often require difficult and lengthy investigations. Employees may exaggerate or even fabricate injuries. At the other end of the spectrum, white-collar criminals, including doctors and lawyers, entice, pay, and conspire with others to defraud the system by creating false or exaggerated claims, over treating, and over prescribing harmful and addictive drugs. Insurance companies ‘pick up the tab,’ passing the cost onto policyholders, taxpayers and the general public.”

 

~ California Department of Insurance, “Workers’ Compensation Insurance Fraud Program”

 

 

Workman’s Compensation Fraud Investigations “WCFI” is really a fascinating aspect of the very few areas of private investigations this Firm specializes in.

 

The reader may have visited various other websites offering dozens and maybe even several dozen areas of private investigations services in combination with either no photographs or moderate to strong use of what is commonly called “clipart” that is not original to the PI firm being virtually studied.

 

This isn’t necessary with this Firm.  For example, the image above is this Firm’s lead investigator and his “War Dog” after closing a spousal surveillance case by and through the use of studying the habits of the principles and merely waiting for them to come to him and confess.

 

It just so happens that this same case involved suspicion and therefore evolved into a WCFI whereupon the unfaithful man with a back injury so severe that work was impossible was caught on video and photographic evidence secured  that proved riding a jet ski and doing tricks was not hindered by that pesky back injury.

 

Frankly speaking, it would be very difficult in today’s economy to employ enough people to service dozens upon dozens of areas of private investigations; therefore, this Firm only offers four areas of private investigations that often branch out into other areas for a total of less than half a dozen in order to provide the best possible service for its clients.

 

At the same time, the use of undercover operatives may very well develop information such as the man with the bad knee who invited a female undercover operative to watch him compete in a mixed martial arts competition and later basketball game while capturing his prowess with her cellphone camera openly with permission.

 

One never knows...

 

Copyright 2004 – 2016 RV Detective Agency

WORKMAN’S COMPENSATION FRAUD INVESTIGATIONS

Employees can and do sustain legitimate injuries on the job while others would rather jet ski, skydive, train in mixed martial arts, hang out at the cross fit gym, lift weights, engage in triathlon events and all while collecting a check on a back, neck, knee, hand, foot or other claimed injury that does not appear to be so on video or photographs.  Let us find out who is failing to meet the duty of candor.

Area of Operations by California Counties

 

Sacramento

San Joaquin

Stanislaus

Merced

Fresno

Kern

Alameda

Santa Clara

 

Coming Soon

 

Los Angeles

Orange

Ventura

Riverside

San Diego