ICW Group’s Special Investigations Unit (SIU) analyzes all work comp claims for fraud within 24 hours of claim creation. Imagine the simplicity and convenience of using ICW Group’s online claim reporting capability in the following scenario:
An ICW Group workers’ compensation policyholder uses ICW Group’s newly launched online claim reporting tool to submit their first notice of loss. Importantly, while this employer reports the claim, they also report their doubts and concerns regarding the validity of the claim.
The policyholder describes how their surveillance video of the employee parking lot captured footage of the employee driving into the lot, parking the vehicle, exiting the vehicle, and walking into the building without incident. Shortly after entering the building, the employee cries out that they were just assaulted. The employee claims to have sustained significant injuries as the result of an assault occurring in the policyholder’s parking lot, delivered by an unknown assailant.
The policyholder, Claims Examiner, and SIU Investigator immediately collaborate seamlessly. We work with the policyholder’s IT Security team to obtain an unadulterated copy of their video. Our SIU Investigator quickly determined that the injured worker was truly assaulted; however, the assault took place off-site and was unrelated to the policyholder.
Despite multiple opportunities to “come clean,” the injured worker continues to maintain their injuries occurred in the policyholder’s parking lot. The claim would have been denied and referred for potential prosecution. Although a hypothetical scenario, events similar to this happen on a regular basis.
Observations from a file review would reveal:
- Ease of online claim reporting
- Rapid collaboration and communication between the policyholder, Claims Examiner and SIU Investigator
- This is a positive example of an employer implementing targeted surveillance for employee safety and deterrence purposes
Current and future ICW Group policyholders are encouraged to visit our website to learn more about how we partner with you to fight fraud.
