Worldwide Intelligence Network has been conducting AOE/COE and Sub Rosa Workers’ Compensation Investigation Services for the past twenty five years. Interviews of claimants and witnesses number in the thousands. Sub Rosa and Activity Check investigations number in the hundreds and are performed by superb experienced field investigators with proven track records. In addition to providing investigative coverage throughout California and New York we provide Workers Compensation claims investigations through our associate network of investigators all across America.
Our Workers’ Compensation investigations have led to several millions of dollars saved by our clients who are insurance companies, self- insured entities and municipalities. Our record of success for establishing fraud is far above the average and our clients are consistently pleased with the quality, efficiency and professionalism of our investigative ability and knowledge of the laws governing Workers’ Compensation claims. We have uncovered potential insurance fraud in over 80% of our investigations – yet no investigation was ever conducted with a preconceived notion that a claimant filed a fraudulent claim. Throughout our twenty five year history we never failed to submit an investigative report on time. Some of our clients:
- State Compensation Insurance Fund
- Los Angeles County Risk Management Division
- Third Party Administrators; Tristar, Aims, Intercare
- MTA Risk Management
- City Attorney of Los Angeles
- Hughes Air Craft El Segundo .
Two Case Studies on Workers’ Compensation Insurance Fraud
[Case Study 1] A claimant reported that he fell down some stairs at work and hurt his back. The claimant saw a doctor who signed a doctor’s note saying the claimant could not return to work for several weeks. When the claimant returned to work he presented another doctor’s note addressed to the “return to work supervisor” stating the claimant was to be given restricted work assignment avoiding any physical lifting of boxes or files. We were assigned to conduct a surveillance investigation on this claimant after our client received an independent physician’s report stating that no injury to the claimant’s back could be found. On the first day of this assignment, video was captured of the claimant lifting and moving furniture into his home which lasted over an entire weekend while he was allegedly incapable of any physical activity. Our date and time stamped video of the claimant’s activities had a dramatic effect on his claimant’s workers’ compensation claim which was denied and subsequently referred to the District Attorney’s Workers’ Compensation Fraud Unit. Over the past several years numerous physicians and attorneys have been investigated, arrested and charged with insurance fraud.
[Case Study 2] We were assigned a surveillance investigation on a claimant who alleged a severe injury to his foot. He had been off work on an accepted claim for over a year. Our client suspected fraud due to an independent physician’s report stating he could not find anything wrong with the claimant’s foot. During our first day of this surveillance we did not find a car parked in front of or in the driveway of the claimant’s home. Further investigation revealed that the claimant’s car was parked in a driveway of a vacant home directly across the street from his house. We found that suspicious since the claimant’s driveway and street were clear of any other vehicles. As the claimant exited his home we captured video of him limping. The problem with his limp was that he was limping on the wrong foot. It appeared most likely to us that the claimant’s attorney may have cautioned him that he could be placed under surveillance and to not leave his car in his driveway or in front of his house so investigators would be unable to know the car he was driving and subsequently have a difficult or impossible time following him. That same day he was observed limping on the wrong foot he was followed and videotaped entering a Chiropractor’s clinic. Prior to walking into the clinic video was taken of him putting on a foot brace that he had in his car and then he took out a pair of crutches from the trunk of his car. When he exited the clinic he took the brace off of his foot and he put the crutches back in the trunk. Surveillance continued for several more days. We then noticed that the license plate on the claimant’s car had been switched which we presumed was an additional effort on his part to avoid detection. We followed the claimant again and videotaped him running in a rain storm without a limp pushing a shopping cart from BevMo’s market through a parking lot. The claimant ceased receiving workers’ compensation and was arrested and charged with workers’ compensation insurance fraud and he is currently awaiting trial.
We welcome Defense Attorneys, TPA’s and Insurance Companies to call or contact us to inquire about our rates and availability. (310) 385- 8200