3175 Sedona Court – Building E., Ontario, California 91764
Toll Free (877) 687-3939/OUR-EYEZ
info@corinthian-group.com

INSURANCE FRAUD INVESTIGATION

insurance fraud investigations - corinthian group

WORKERS COMPENSATION, INSURANCE FRAUD AND SIU

Corinthian Group understands the needs of our clients and works collaboratively with employers, insurance adjusters, defense counsel and TPA’s to insure that they are prepared “In Advance” for upcoming depositions, hearings and mediations, etc. We understand that our clients are managing multiple cases simultaneously, so it is our responsibility to help our clients successfully manage all cases assigned to our firm by being knowledgeable on the logistics of each case. Each case assigned to our agency will be managed by one of our knowledgably Investigative Technicians. Investigative Technician will work closely with claims professionals and defense attorneys to develop a synergistic bond which will insure that each case is managed efficiently. Corinthian Group’s Investigative Technicians will be there to remind our valued clients that an upcoming deposition is quickly approaching and will request authorization if additional investigation is warranted.

Corinthian Group stands ready to serve our clients, anytime or anywhere with little to no notice.

When you look good, we look good!!! “Corinthian Group is your strategic partner in claims mitigation”…

WORKERS COMPENSATION LAWS

Defense Attorneys, Employers, Claims Adjusters/TPA, and self-insurers utilize Workers’ Compensation fraud investigation services to assist in identifying and obtaining admissible evidence to refute and or mitigate fraudulent claims.

Each state has their own workers compensation laws, which was established to protect employees who sustained injuries as a result of work performed while employed by a specific employer or that occurred during the course of employment (AOE/COE = Arising Out of Employment & in the Course Of Employment). However, the Workers Compensation Laws are often misused by employees who in one way or another are fraudulently receiving unwarranted compensation. Federal employees are entitled to 2/3 of their monthly salaries when out on disability and even more if they can prove their injury is permanent. Workers compensation fraud costs taxpayers 60 billion dollars every year. In California, many businesses have left the state because of increased workers compensation premiums for their employees due to enormous fraud. Many businesses have moved to tax & business friendly Nevada. California is hurting financially and the mass exodus of jobs to Nevada is not helping… From increased fees to the employer down to increased taxes & loss of jobs to the taxpayers, fraud affects everyone! It is the responsibility of employers to investigate each individual case to so that they don’t become victims of fraud…

AOE/COE INVESTIGATIONS

An integral facet of the claims investigation process is the conducting of interviews relating to AOE/COE (“Arising Out of Employment or in the Course of Employment”) investigations. However, we have noticed that some investigators who specialize in AOE/COE fail to fully obtain important information that could be used in the future as evidence in building a fraud case for prosecution and or fail to provide basic information that would be useful to the investigators who might be contracted to conduct surveillance.

Corinthian Group utilizes experienced and highly trained investigative professionals to insure that our clients receive a thorough and information laden AOE/COE investigative report. Our AOE/COE investigators either have experience in surveillance and or have experience in building fraud cases for prosecution. We believe that both experiences are necessary for optimal claims mitigation. Our 1st objective is to make sure that the Defense Attorney has every bit of potential evidence that could be used to mitigate the claim at the initial deposition. Our 2nd objective is to make sure that the surveillance investigators as well as everyone involved in an individual case have any and all relevant personal information (verified whenever possible). Our 3rd objective is to strategically ask important questions during the interview that could be used as potential evidence in proving fraud.

When a competent investigator has the opportunity to manage a claims case from beginning to end and also has the experience to manage each case with short term & long term goals in mind, the overall efficiency of everyone involved in the case will ultimately skyrocket…

RETURN TO WORK

Employees will often seek and obtain full or part time “under the table” jobs where they can earn cash or additional income in an attempt to avoid discovery. It is quite easy for a claimant to sustain or even increase their standard of living with part time employment and a guaranteed disability paycheck. These individuals truly believe in “working smarter and not harder”, at the expense of others…

Here are just a few benefits to claimants on disability:

  • Receiving a portion of their monthly income while at home.
  • Receiving medical treatment for injuries that may or may have not been sustained by their current employer.
  • The potential to obtain additional revenue from other income sources and or job training in an alternate career path.
  • More time with family and friends.
  • Extended vacation, with a possible paid vacation in the future…
  • A large pay day if they can successfully milk the injury and the system unimpeded.
Claimant’s have very little incentive to return to work when employers allow claims to go uninvestigated. However, if while conducting a workers compensation investigation investigators discovery evidence that proves the claimant/injured party is no longer injured and can return to work in a productive manner, workers compensation benefits can then be terminated.

In our experience, we have learned that the vast majority of injuries are real and have taken place as the claimant indicated. However, the majority of these claimants exaggerate the severity of their injuries. Thus, many employers & taxpayers have unknowingly funded a healed claimant’s lifestyle and extended vacation. Corinthian Group investigations will frequently reveal claimants that have not been dishonest about the severity of the injuries, determine if they are working somewhere else and obtain the irrefutable evidence needed. If there is not enough sufficient evidence to send to the District Attorney for a fraud case, our investigative efforts will no doubt get them to return to work sooner rather than later…

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