Corporate Risk & Workers' Comp Fraud Intelligence
Corporate Risk & Workers' Comp Fraud Intelligence supports employers, adjusters, and defense counsel who must separate legitimate workplace injuries from exaggerated or fabricated claims. With a background in corporate fraud and legal compliance, we structure each inquiry to withstand scrutiny from opposing counsel, regulators, and the court.
We typically begin with a claimant background review to identify prior claims, injury patterns, and any relevant criminal or civil history. From there, we design an investigation plan that may include workplace or field surveillance, injury verification, witness interviews, and focused OSINT research. The goal is not to harass claimants, but to document actual functional abilities and compare them to reported limitations and medical restrictions.
During surveillance, our investigators observe and record activities such as lifting, driving, recreational pursuits, and secondary employment when encountered in public view. Injury verification efforts may involve corroborating timelines, reviewing records provided by counsel, and noting discrepancies between reported pain levels and observable behavior. Witness accounts-from co-workers, supervisors, or bystanders-are taken using structured interview techniques so their statements are clearer and more usable.
If indicators of fraud emerge, we organize the evidence into concise, chronology-based reports, accompanied by still images or video when lawfully obtained. Our documentation is formatted with the needs of insurance defense and corporate counsel in mind, making it easier to evaluate claim exposure, pursue subrogation, or refer egregious cases for criminal review.
For honest claimants, our work can help confirm the legitimacy of their injuries, supporting appropriate benefits and closing files with confidence. For questionable claims, it provides the factual foundation needed to deny or limit payouts, negotiate more favorable settlements, or contest the matter at hearing.
In every case, you gain clearer insight into risk, enabling more accurate reserving, fewer surprise costs, and stronger deterrence against future fraudulent activity.
We typically begin with a claimant background review to identify prior claims, injury patterns, and any relevant criminal or civil history. From there, we design an investigation plan that may include workplace or field surveillance, injury verification, witness interviews, and focused OSINT research. The goal is not to harass claimants, but to document actual functional abilities and compare them to reported limitations and medical restrictions.
During surveillance, our investigators observe and record activities such as lifting, driving, recreational pursuits, and secondary employment when encountered in public view. Injury verification efforts may involve corroborating timelines, reviewing records provided by counsel, and noting discrepancies between reported pain levels and observable behavior. Witness accounts-from co-workers, supervisors, or bystanders-are taken using structured interview techniques so their statements are clearer and more usable.
If indicators of fraud emerge, we organize the evidence into concise, chronology-based reports, accompanied by still images or video when lawfully obtained. Our documentation is formatted with the needs of insurance defense and corporate counsel in mind, making it easier to evaluate claim exposure, pursue subrogation, or refer egregious cases for criminal review.
For honest claimants, our work can help confirm the legitimacy of their injuries, supporting appropriate benefits and closing files with confidence. For questionable claims, it provides the factual foundation needed to deny or limit payouts, negotiate more favorable settlements, or contest the matter at hearing.
In every case, you gain clearer insight into risk, enabling more accurate reserving, fewer surprise costs, and stronger deterrence against future fraudulent activity.
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