Worker Compensation Investigations

 

Florida law provides for harsh penalties for workers' compensation fraud. Under Florida law, two types of workers' compensation fraud can be alleged, including claimant fraud and premium fraud. Both employees and employers can face charges for fraud in these cases.

Workers' compensation fraud occurs in Florida when a person knowingly and with intent to injure, defraud or deceive any employer or employee, self-insured program, or insurance carrier, files false or misleading information. In Florida, workers' compensation fraud is a third degree felony that carries penalties including fines and up to 5 years in prison. The courts can also impose civil liability for fraud involving workers' compensation.

Florida law also provides rewards of up to $25,000 for individuals who provide information that leads to an arrest and conviction for any person committing insurance fraud. Many claims begin with a report of insurance fraud to the Florida Division of Workers' Compensation. 

Claimant Fraud in a Workers' Compensation Case

 

An allegation of claimant fraud can arise when an employee receives wage replacement benefits after making false statements or under other false pretenses. In these cases, the employee that makes the fraudulent claim may lie about the injury occurring on the job as opposed to away from the job.

These cases also involve alleged lies about the injury and its seriousness. In many of these cases, it is alleged that the employee has overstated the extent of the injury. If the employee lies about the injury and then works and receives other unreported income, claimant fraud can be charged.

Many of these cases involve allegations against medical practitioners and healthcare workers charged with racking up excessive treatments. In other cases it is alleged that the treatments never occurred at all. Claims can even be brought against attorneys and other professionals who are involved in such cases.

Premium Workers' Compensation Fraud

 

Fraud related to paying the premiums for workers' compensation insurance is a serious offense and can be charged as a first degree felony in Florida. Under Florida law, premium fraud occurs in Workers' Compensation cases when the employers try to cheat their insurance carrier or avoid having any workers' compensation coverage at all when it is required. Premium scams include:

  • Under reporting the number of employees on payroll; or

  • Misclassifying different employees using an improper loss experience factor, paying employees in cash while listing them as subcontractors.

Why hire a private investigator for Worker Compensation matters?

 

Insurance providers, among others, can benefit by hiring a private investigator to gather evidence and information related to the claim. When an employee makes a claim that he or she was injured while working, the professional investigators from Midstate Security and Investigations, LLC will conduct a thorough investigation, which could include:

 

  • Thoroughly examining the location where the alleged accident or incident occurred.

  • Examining any machinery and tools that may have relevance.

  • Reviewing any video from surveillance cameras.

  • Interviewing coworkers and other potential witnesses.

  • Inspecting safety records and assessing safety protocols.

  • Determining if the employee has a history of worker compensation claims.

Call Midstate Security and Investigations, LLC today for a free, no-obligation assessment of your needs.

Florida Agency License No. A16000285, B16000297

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