Exposing Fraud. Defending Employers. Protecting Insurers.
Workers’ compensation is designed to protect employees who are injured on the job, ensuring they receive proper medical care and wage replacement during recovery. Unfortunately, not everyone plays by the rules. Workers’ compensation fraud is a growing concern for businesses, insurance carriers, and government agencies across Florida—and the cost of fraudulent claims can be devastating.
At Eyes on You Investigations, Inc., we specialize in identifying, documenting, and helping to prosecute both claimant fraud and premium fraud. Our experienced investigators work closely with insurance companies, defense attorneys, employers, and risk managers to gather clear, admissible evidence that uncovers the truth and supports rightful outcomes.
What Is Workers’ Compensation Fraud?
Workers’ compensation fraud occurs when an individual or business knowingly and intentionally provides false or misleading information in order to obtain, deny, or reduce workers’ comp benefits. This can involve injured workers, employers, medical providers, or even attorneys acting in bad faith.
The two most common types of workers’ compensation fraud are:
Claimant Fraud
Claimant fraud occurs when an employee files a false or exaggerated claim to receive benefits they are not entitled to. This may include:
- Claiming an injury occurred at work when it happened off-site (e.g., at home or during personal activities)
- Faking an injury or illness entirely
- Exaggerating the severity of a real injury
- Working another job while collecting benefits and failing to disclose that income
- Receiving unnecessary or fake treatments from dishonest medical providers
Some fraudulent claims are part of larger networks involving unethical doctors, pharmacies, and attorneys. These actors conspire to generate billings for unnecessary or nonexistent treatments, file excessive claims, and exploit loopholes for financial gain.
Premium Fraud
Employers commit premium fraud when they attempt to lower their workers’ compensation insurance premiums by misrepresenting important business information. Common tactics include:
- Underreporting total payroll to reduce premium costs
- Misclassifying employees’ job duties to fall into lower-risk (and cheaper) categories
- Paying employees in cash or under-the-table and falsely labeling them as subcontractors
- Hiring undocumented workers and failing to report them
- Failing to report legitimate work-related injuries to avoid insurance rate increases
- Operating without any workers’ compensation coverage when legally required to do so
Premium fraud can lead to serious consequences—including criminal charges, business closure, and civil penalties. We help expose these practices and protect honest businesses from unfair competition.
How We Investigate Workers’ Compensation Fraud
Our investigation process begins with a confidential consultation where we review the known facts, identify red flags, and determine the appropriate surveillance or background checks. We then assign trained field investigators to document the claimant’s behavior and daily activity, looking for inconsistencies between their reported limitations and actual capabilities.
Our Investigation Services Include:
- Background Checks: We search for prior workers’ compensation claims filed by the subject across state and national databases. Repeat filers often follow familiar patterns.
- Field Surveillance: Our investigators monitor the claimant’s daily activities to document whether they are working, engaging in physical activity, or violating doctor-recommended restrictions.
- Video & Photo Documentation: We capture time-stamped evidence of any behavior inconsistent with reported injuries—such as lifting heavy items, climbing ladders, or recreational activity.
- Social Media Monitoring: Many claimants unknowingly post incriminating evidence online. We track and archive social content that may contradict the claim.
- Witness Interviews: When necessary, we speak with coworkers, neighbors, or associates who can offer insight into the claimant’s behavior or employment status.
- Report Preparation: We compile detailed investigative reports that include all findings, surveillance logs, photo/video evidence, and professional analysis.
Real-World Case Examples
Case 1 – “Too Injured to Work”: A warehouse employee claimed a back injury prevented him from standing for more than 15 minutes. Our video showed him working as a furniture mover on weekends—lifting heavy couches and driving trucks. The claim was denied and referred for prosecution.
Case 2 – Premium Fraud Uncovered: A roofing company reported only five employees to its insurance provider, while employing more than 20 workers paid in cash. Our undercover footage, job site interviews, and drone photos provided the insurer with enough evidence to file civil action and revoke coverage.
Case 3 – Doctor and Patient Collusion: A claimant and their physician reported ongoing severe pain and therapy needs. Our team tracked the claimant attending concerts, shopping, and engaging in strenuous exercise. The doctor later lost their license after multiple similar cases were uncovered.
Who We Work With
- Insurance Companies: Validate claims and prevent costly payouts on fraudulent cases.
- Employers: Confirm suspicions about employees abusing benefits or falsifying injuries.
- Law Firms: Support defense strategies and secure case dismissals with admissible evidence.
- Third-Party Administrators (TPAs): Manage high volumes of claims with professional investigative support.
Why Choose Eyes on You Investigations?
- Proven Results: Over 40 years of combined experience in surveillance and fraud investigations.
- Legal Compliance: Our methods follow state and federal guidelines for admissibility.
- Rapid Deployment: We respond quickly to emerging claims to capture early evidence.
- Comprehensive Reporting: Our detailed reports include visuals, timestamps, and narrative context that hold up in court or insurance hearings.
- Discreet & Professional: Claimants never know they’re being watched. Your investigation remains confidential at all times.
Contact Us to Report Suspicious Activity
If you believe someone is abusing the workers’ compensation system—whether it’s an employee, employer, or service provider—don’t wait. Fraudulent claims impact everyone through higher premiums, lost productivity, and wasted resources.
Eyes on You Investigations, Inc. is ready to assist. We work with private industry, legal professionals, and insurers across Florida to expose fraud and build strong cases for denial, recovery, or prosecution.
📞 Call now for a confidential consultation: (305)244-1953
