The National Insurance Crime Bureau reports that fraud among workers’ compensation claims costs insurers and employers about $7.2 billion every year. Pennsylvania workers could be interested to learn that insurers are turning to social media and surveillance to detect dishonest workers.
In California alone, workers’ compensation fraud investigators identified more than 5,700 potential fraud cases during the 2014 fiscal year. With 255 arrests and 248 cases referred for prosecution, insurance companies lost about $242.7 million during the period. However, insurance departments in the state and elsewhere actively use social media and other surveillance when they investigate possible workers’ compensation fraud.
Several signs point to an employee who could be fraudulently claiming workers’ compensation, according to a small business insurer. These include contradictory descriptions of the workplace accident, a history of compensation claims, no witnesses and reporting an injury from the prior week on Monday morning.
When claims seem suspicious, social media and surveillance are two methods of verifying them. Social media could provide photos of injured workers participating in activities or work that their claims say they cannot do. These platforms may help verify the residences of these individuals through photos that could contain metadata such as where and when the photos were taken.
Social media can be an effective method of confirming an alibi, confirming other policy application information, locating witnesses, and verifying disability status. It can also be used as a precursor for surveillance, which is more expensive. By looking through social media first, claims investigators can save time and money waiting for an injured worker to be spotted.
When employees suffer from workplace accidents and injuries, they need to report them right away so that it does not appear like they are lying if they report them later. If they are wrongly accused of committing fraud for some reason, they could obtain the assistance of workers’ compensation attorneys to help them gather evidence to support their claims.
Rubin, Glickman, Steinberg & Gifford P.C.
Pennsylvania Attorney's
March 29, 2016
