Workman’s Comp. : Employer’s Success Story : ALI Agency – Expert Fraud Investigators
The Director of Human Resources at a large company, met with our Director of Investigations for a Free Case Consultation to determine if ALI Agency’s services would benefit them in a pending Workman’s Comp case.
While reviewing the employee claim and injury report- several red flags were noticed by a trained workman’s comp fraud investigator on our team. ALI Agency was hired by the companies insurance carrier to conduct a due diligence investigation.
The ALI expert fraud investigator confirmed that the claimant was burned during his employment with the company. However, when the physician released him back to work – he claimed he was still too injured. Part of the claim included the employee had developed:
- An extreme Fear of both fire and light
- Total inability to interact socially
- 100% Complete vision impairment
The ALI agency case manager determined that the scale of his injuries did not match the employee’s claims, and started surveillance immediately.
During the initial surveillance, the investigator noted scraps of electrical components / wiring, and got a tip about the claimants activity at a local hardware store. Over the course of a few weeks, our team of expert surveillance Investigators produced a large amount of evidence.
The ALI Agency proved the claimant was in fact:
- performing electrical services in exchange for money
- driving day and night with put the use of eye protection – ever
- doing intense yard work / lighting burn piles
- socializing with lady friends on several occasions
Conclusion: The employee had retained a lawyer to help get compensation for his injury. The companies insurance adjuster presented the evidence once ALI Agency’s investigation was complete – and the pending lawsuit was dropped immediately. The employee was denied benefits and lost his position. The company saved thousands of dollars in fraudulent claim settlement costs.
Because of the high level of thoroughness that the ALI Agency Expert workman’s comp investigator put into this case, we were able to add another successful fraud investigation to our portfolio. Fraudulent Workman’s Comp and insurance claim files are an increasing epidemic – costing tax payers in this country millions of dollars a year. We are here to help reduce that amount!