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Workers’ comp insurers use social media to combat fraud


Workers’ comp insurers use social media to combat fraud

South Carolina employees may not be aware that insurance companies routinely use surveillance and social media to investigate workers’ compensation claims. According to the National Insurance Crime Bureau, fraudulent claims cost insurers around $7.2 billion annually.

Insurance experts say that several things may tip off an insurance company that a claim is suspicious, including people with a history of claims, accident reports with no witnesses, conflicting reports of the way an injury happened and a delay in making a claim. To verify questionable reports, investigators may observe claimants’ Facebook pages for proof they are participating in activities counter to their injury claim. For example, in 2014, an Ohio woman claimed she fell at work but posted on social media that she fell at a gas station. She was charged with filing a false claim and given a suspended sentence of 180 days in jail. She was also ordered to pay back $1,908.76 in workers’ compensation benefits and $200 in court fees.

Fraud experts say that social media and Internet research can provide investigators with dozens of clues regarding a claim’s legitimacy. These clues may include a claimant’s policy application information, an alibi and the facts of loss. Social media can also be used to track down witnesses to an accident.

South Carolina workers who are injured on the job may have the right to file for workers’ compensation benefits, which can include a percentage of lost wages as well as medical care. An attorney can often assist during the filing process as well as in subsequent hearings and appeals if the claim is denied.