Monday, June 13, 2011

Claimant Arrested for Fraud

As reported in this article a claimant was indicted on suspicion of stealing $140000 in funds from Pinnacol Assurance, the insurer handling more workers compensation claims in Colorado then anyone else. The spouse was also indicted. In my experience this is relatively rare. A claimant may exaggerate his condition but seldom is it outright fraud. Some employers are much more likely in my experience to intentionally coverup claims made by employees. In any event this news is unfortunate as it suggests that surveillance be used in many cases. There are many claimants who must be put through this process even though they have legitimate injuries. Yet insurers do not just look for fraud they also look for any possible evidence that helps them to defend the claim. There are very few arrests but there are many cases where the insurer has evidence the claimant can do more then is recommended by his doctors. So judges may be shown this but also doctors. If you exceed your restrictions and that is videotaped then your case has not only been weakened but your doctor may become quite upset with you which also makes him question your treatment and future needs.

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