COMMON INDICATORS OF A FRAUDULENT CLAIM

  • Tips from neighbors, relatives, friends or co-workers that a claimant is actually more active than alleged.

 

  • The injury coincided with a company’s reduction of their work force.

 

  • The reports coming from nurse case managers, doctors and therapist report a healthier and more  active claimant than what is alleged.

 

  • The lack of organic basis for the disability. Most of the complaints and allegations are subjective.

 

  • Premature or excessive demands for compensation.

 

  • The claimant worked in a seasonal occupation.

 

  • The claimant often misses their therapy and or doctor appointments.

 

  • “Dueling Doctors”.  One doctor may state that the claimant is disabled while another reports a completely different prognosis indicating he or she is NOT disabled.

 

  • There were no witnesses to the reported accident.

 

  • The claim was not reported until after the claimant was terminated, suspended or had resigned.

 

  • The claimant had only been employed for a short while when the alleged accident occurred.

 

  • The claimant is often not home, or you are advised that they are not available.

 

  • The claimant is disabled longer than is normally associated with the reported injury.

 

  • The claimant has a history of claims or short-term employment.

 

  • The claimant’s job performance was below par, was recently disciplined at work or they were nearing the end of a probationary period.

 

  • A social network check or activity check indicates a more active claimant than alleged.

 

  • The claimant has a history of financial problems.

 

  • Course of treatment is questionable. Minor injuries resulting in extensive medical treatment and diagnostic testing.

 

  • Damage to vehicle is inconsistent with the claimed injuries.

 

  • Documentation of treatment is suspect.  Photocopies of bills, no record of dates of treatment, no itemization, etc.

 

  • Multiple occupants treating with the same medical providers.

RBH&A's team of private investigators are ready to conduct surveillance on your subject to verify the validity of the claim.