Are employers at risk not knowing about an employee’s background?

When a person applies for a job, they typically submit information about their work history, education, skills, and references.  The employer will validate the information provided, and depending on the job, may also run a background search as well.  The results of this information, and how well the applicant qualifies for the job will likely determine if they are hired or not.

Now, skip ahead 3 months after that person was hired.  The employee has filed a worker’s compensation claim stating they were injured on the job.  At first glance, this isn’t something new.  Employees get injured all the time at work.  It is still the responsibility of the employer or insured to have the claim investigated.

This is where you may learn the employee has a history of similar claims, an unknown criminal background, and/or other vital information about their past.  The situation just went from a typical honest claim to a potentially fraudulent claim.

Some Worker’s Compensations statistics:

  • More than one in 10 small-business owners are concerned an employee will fake an injury or illness to steal Workers Compensation benefits.
  • Nearly one in four business owners have installed surveillance cameras to monitor employees on the job.
  • One in five business owners feel unsure how to identify Workers Compensation scams, and
  • More than half agree these are fraud flags: Employee has a history of claims include: (58 percent); no witnesses to the incident (52 percent); employee didn’t report the injury or illness in a timely manner (52 percent); and the injury coincides with a change in employment status (51 percent).

(Employers Holdings, July 2015)

Fraud has become more complex, and often involve multiple industries rather than just insurance. An insurance investigation, for instance, might reveal evidence of financial fraud.

  • 84 percent of insurance organizations say fraud cases they investigate involve more than one industry;
  • 76 percent of cross-industry fraud cases have a moderate to high impact on insurance organizations;
  • More than half say these cases (61 percent) have severe impact on responding insurance organizations;
  • Fraud schemes of high concern: identity theft (49 percent), hacking (45 percent), employee-agent (37 percent) and claims (34 percent). (LexisNexis, June 2016)
  • Fraud has become more complex, and often involve multiple industries rather than just insurance. An insurance investigation, for instance, might reveal evidence of financial fraud.

What is the next step if you think the employee’s claim is possibly fraudulent, and how can you protect your company?

There are several investigative services available to research and defend against possible fraud.  One of the most commonly used is a Comprehensive Background Search.

A Comprehensive Background Search can expose valuable information related to your subject and identify historical data that can be used during litigation of a claim.  It may uncover patterns of behavior, confirm civil and/or criminal history, previous workers’ compensation claims and lawsuits, expose financial distress and/or bankruptcies, and much more.

Although this data is extremely important, it could only be the start to how much evidence you can obtain.  The information can lead to further investigative means, such as Medical Canvassing, an Open Source Media Search, and even physical surveillance.

Using these types of investigative services provided by licensed and certified professionals can help tip the scales in your favor in defending against fraud.

Let us help you defend against possible fraud.

When you need to records and intelligence on your claimant, GII has you covered. Our Analysts and Researchers can obtain various records and perform comprehensive background reports on your claimant in record breaking time.

Here are some of the Investigative Services available:

  • Comprehensive Background Reports
  • Asset Checks
  • Business Affiliation Search
  • Records Request
  • Employment Screening
  • Civil and/or Criminal Records Search
  • Employment Search and Verification
  • Person Locates
  • Professional License Search
  • Recreational License Search
  • Driving Records
  • Social Security Number Search
  • Motor Vehicle Records

Let us get you the results you need on your next claim. We have made it as easy, simple, and convenient as possible, with our online case request form to submit your referrals.

Submit your case request online and see the difference with GII.