Workers' compensation insurers look to social media to combat fraud

February 28, 2014 (Press-News.org) Workers' compensation insurers look to social media to combat fraud

Article provided by Silverman, Silverman & Seligman, P.C.
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Social media updates keep our friends and acquaintances in touch with our day-to-day lives. But more than just friends have access to personal information posted online. Law enforcement, divorce lawyers, the IRS and insurance companies may all use social media such as Facebook to collect information on suspects, ex-spouses, taxpayers and insurance claimants.

Workers comp claims receive scrutiny

Workers who suffer an injury while performing job duties are eligible to receive workers' compensation benefits. These benefits allow a worker to receive income that would otherwise be lost because of an inability to work. In exchange, the worker agrees not to pursue litigation against the company. However, as with all insurance claims, insurers are on the lookout for fraud and the ability to deny coverage based on medical evidence.

As such, insurance companies are diligent about investigating claims for workers compensation. It is not unusual for workers' comp insurers to hire private investigators to tail claimants in order to obtain photographs of the person performing activities that are incompatible with what is claimed for insurance purposes.

Fraudulently claiming a disability is an unfortunate occurrence in the disability field; recently, The New York Times reported on several former New York City police who were charged with fraudulently claiming disability in order to receive Social Security Disability benefits. Four individuals were arrested for directing hundreds of retired police and firefighters to claim a mental illness which they did not suffer, many of whom used the attacks on September 11, as the cause of anxiety, depression and post-traumatic stress disorder. Such acts make it more difficult for legitimately disabled people to receive benefits. Investigators used Facebook as part of the investigation to determine fraud.

Not all claimants "caught" in compromising photographs are guilty of fraud, however. Photos captured at just the right instant can give a wrong impression. Most severely injured people celebrate minor victories in recovery, for example, but posting such information online can actually damage a case and lead an insurance company to deny workers' compensation benefits.

In some cases, private investigators have been known to instigate situations in which a claimant may seem healthier than he or she really is. One private investigator told NewsOK, for example, that he has known PIs who would throw trash on a claimant's lawn on trash day in order to collect photos of that person picking up the yard. Not all PIs are so unscrupulous, of course, but it does demonstrate the interest insurers have in collecting health information on workers' comp claimants.

An attorney can help

Filing a workers' compensation claim can take a lower priority for injured workers who are seeking to recover in good faith. However, because of the high stakes for insurers and companies invested in workers' comp, having a comprehensive, fact-driven claim about an injury and its limitation can be vital for an injured worker who needs insurance money to pay for basic living expenses. People injured at work should contact an experienced workers' compensation attorney to discuss their situation and avoid common pitfalls of a workers' comp claim.