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.
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 RV Detective Agency
WORKMAN’S COMPENSATION FRAUD INVESTIGATIONS
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