In a case highlighting the critical role of ethical compliance, Frasco Investigative Services successfully brought to light workers’ compensation fraud thanks to a routine Alive and Well investigation.
Background:
- Following a work-related accident in 1997, the employee was rendered unable to work and entitled to insurance benefits.
- Pursuant to a negotiated settlement of the insurance claim, the claimant was to receive $18,000+ in monthly workers’ compensation payments for the remainder of his life. The benefits were to conclude upon his future death.
- The claimant ultimately passed away in 2010.
- Despite the passing of the claimant, his wife intentionally did not disclose the passing of her husband as required by the settlement agreement and continued to collect benefits for years, perpetuating a multi-million-dollar fraud.
Frasco’s Intervention:
Frasco investigators, during the course of a routine Alive and Well Check, uncovered the discrepancies in the claim. The Alive and Well investigation proved instrumental in:
- Unmasking the fraudulent activity.
- Providing irrefutable evidence to authorities.
- Ensuring justice was served, with the wife facing legal consequences.
Lessons Learned:
This case serves as a stark reminder of the subtle nature of fraud and the importance of robust risk management. By partnering with Frasco, organizations can:
- Implement proactive measures to safeguard against potential fraud and abuse of the insurance claim process.
- Leverage our expertise to conduct thorough investigations and uncover any potential wrongdoing.
- Maintain confidence in the insurance claim process and ensure that benefits are paid only when appropriate.
Frasco Investigative Services – Protecting Your Assets, One Investigation at a Time.
