January 6, 2020 /


Discovering a WSIB Fraud

The Workplace Safety and Insurance Board (WSIB) is the official body that gives compensation and insurance to workers who are entitled to obtain WSIB benefits. It operates in compliance with the Workplace Safety and Insurance Act.

According to the WSIB, most claims-related fraud by injured workers is a myth.

Like other fraudulent claims, an employee may decide to obtain WSIB benefits to which he/she is not entitled – an action to defraud the WSIB. YES! Employees do that too, don’t be caught unawares. Common types of WSIB fraud claims you can expect to include bodily injury claims, accident benefits claim, casualty claims, theft claims, and more.

As an employer, what is the first thing you do when your employee submits an insurance premium claim, and how do you check its authenticity? You are safer to know that not all claims made by your employees to the WSIB that is true. Sometimes, some claims can be a falsehood. How then do you recognize this?

Likely options are either you play recent videos from the surveillance cameras, ask for a witness, or probably study the record of the victim if he/she was involved in some likely claims or a fraud action.

Conversely, in most cases, employers leverage the intelligence of an experienced Private Investigator in Toronto, like PIPRO, to help them determine if fraud or wrongdoing is occurring.

However, we highlight the top 7 red flags below in discovering a fraudulent WSIB claim:

Top 7 Red Flags in Discovering a WSIB Fraud

#1 Watch out for “No Witnesses and Details” Claim

When your workers submit an insurance claim, it lies between falsehood or a true claim. And if there are no surveillance cameras around to detect such claim, your close alternative is to ask for a witness. If there are no witnesses to the incident and an employee’s accident details do not provide logical support, it is likely a red flag.

#2 Suspicious Actions

When an employee is avoiding medical attention or treatment to the alleged injury, there’s a chance of the claim may be fraudulent.

#3 Questionable Lifestyle

If the claimant’s lifestyle does not tally with his income, or they live rather too high than what they earn.

#4 Questionable Claimant Whereabouts

When a reported accident occurs where the claimant would not normally be or is not expected to be during a work hour, there’s a chance of a fraudulent claim.

#5 Questionable Employee Record

If the claimant is new to a job or has a history of short jobs, then it could be a chance of a fraudulent claim. Watch out!

#6 Questionable Timing

The alleged accident occurs early Monday morning, or late Friday afternoon but not reported till Monday morning.

#7 Questionable Changes

The employee has a history of frequently changing physicians, changing past employment records, or frequent address changes. Related experience shows that when any two of these are present in a claim, it may just be fraudulent.

Final Thoughts

Since fake WSIB claims can cost you a lot of bucks and time to correct its cause, it is to be investigated immediately you suspect any fraudulent actions.

Provided you need help in discovering a WSIB Fraud, hire the best Private Investigator in Toronto TODAY to help you uncover the truth behind a WSIB claim. At PIPRO, we engage the best investigative techniques that uncover a WSIB fraud efficiently, including Field Visits, Witness Locates, Video & Photographic Surveillance, and Inquiries & Interviews. Get started by placing a call through on 416-912-7755.