Large, self-insured companies face unique challenges in managing insurance claims. Unlike traditional insured businesses that rely on carriers, self-insured organizations bear the financial risk for their claims, making cost control, fraud mitigation, compliance, and operational efficiency critical concerns.
So, how have many companies countered the concerns? By leveraging investigative expertise, utilizing advanced technology, and applying industry best practices, they optimize claims outcomes and reduce financial exposure—capabilities found with Frasco Investigative Services.
Addressing Pain Points for Self-Insured Companies
1. Rising Claims Costs and Leakage
Self-insured companies must actively manage their claims to avoid unnecessary expenses. Claims leakage happens when inefficiencies, fraud, or poor oversight push costs higher. Moreover, without the proper controls, claims remain open longer than needed, leading to excessive payouts.
How Frasco Helps:
- Conducts comprehensive investigations to verify claim legitimacy.
- Utilizes AI-driven analytics to detect inconsistencies and patterns of abuse.
- Offers surveillance and field investigations to confirm injury status and recovery progress.
2. Fraud, Waste, and Abuse
Fraudulent and exaggerated claims are a significant concern for self-insured companies, especially in high-risk industries. Workers’ compensation, liability, and disability claims are vulnerable to fraud schemes, increasing the financial burden.
How Frasco Helps:
- Performs covert and overt investigations to document fraudulent activities.
- Implements social media and digital forensics to uncover claim inconsistencies.
- Conducts background checks and social media audits to uncover activity levels inconsistent with medical restrictions.
3. Compliance and Regulatory Risks
Managing claims requires strict compliance with state and federal regulations. Additionally, non-compliance can lead to fines, lawsuits, and reputational harm.
How Frasco Helps:
- Ensures claims investigations meet legal and ethical standards.
- Provides expert reports and testimony to support compliance efforts.
- Assists with Alive and Well checks to verify long-term claims eligibility.
4. Malingering Claims
Extended disability claims increase costs and reduce workforce productivity. Many claims stay open longer than necessary due to lack of medical proof or unwillingness to return.
How Frasco Helps:
- Conducts activity verification to confirm an employee’s physical restrictions and abilities.
- Obtains objective documentation for medical review.
- Works with claims personnel, TPAs and legal teams to provide supporting investigative findings.
5. Lack of Actionable Data and Analytics
Without good analytics, self-insured companies find it hard to track trends, measure investigation success, and forecast potential risks.
How Frasco Helps:
- Provides customized claims intelligence reports with fraud detection insights.
- Utilizes data-driven risk assessment tools to optimize claims management.
- Enhances claims monitoring through predictive analytics and reporting.
The Frasco Advantage for Self-Insured Companies
1. Nationwide Investigative Coverage
Frasco delivers coast-to-coast investigative services, ensuring no claim is out of reach. Moreover, our field investigators, digital analysts, and SIU professionals offer thorough support at every step of the claims process.
2. Technology-Driven Solutions
We integrate AI, predictive modeling, and real-time data analysis to enhance claims investigations for self-insured companies. Our advanced social media intelligence and geospatial analytics provide deeper insights into claim validity.
3. Customizable Solutions
We tailor our investigative strategies to match self-insured companies’ claims processes, industry standards, and financial targets. Whether you need help with workers’ comp, liability, auto, or disability claims, Frasco adapts to your needs. Our services range from aiding claims personnel with surveillance and investigations to full SIU program management.
4. Cost Reduction and ROI Optimization
Frasco’s investigative efforts lead to shorter claim lifecycles, fewer fraudulent payouts, and lower total claims costs. Because of our proactive tactics, clients see notable ROI through better efficiency and effective fraud prevention.
Build a Stronger Claims Strategy with Frasco
Managing claims effectively is crucial for self-insured companies wanting to limit costs, lower risks, and improve results. Frasco Investigative Services provides the experience, methods, and tools required to solve the biggest claims challenges.
By partnering with Frasco, self-insured organizations can shift from a reactive to a proactive claims management approach, cutting losses and ensuring compliance and operational efficiency.
Contact Frasco now to discover how we can refine your claims management processes and secure your bottom line.
Contact Us Today
Frasco® Investigative Services delivers ethical and efficient solutions tailored to your needs. Have questions or want to discuss your investigative needs further? Contact one of our experienced experts today to find the answers you’re looking for.
Disclaimer: This blog post offers information only and should not serve as legal advice. Please consult your general counsel for specific legal guidance. Frasco investigators hold licenses, and we ensure our operations comply with US industry, federal, state, and local laws.