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Anatomy of an Insurance Fraud Investigation

Mar 28, 2026 7 min read

A regional carrier engaged us on a workers' compensation claim that didn't add up. The claimant reported a debilitating back injury that ruled out lifting, prolonged standing, or any physical labor. The medical record supported the diagnosis. But the activity didn't match the disability.

We opened with a 72-hour pattern-of-life review. Public records, social presence, and routine observation — nothing intrusive, nothing unlawful. By day two, we had a baseline.

On day four, sub-rosa surveillance documented the claimant performing exterior carpentry work at a second residence: lifting, climbing, working overhead, and continuing for several hours without visible discomfort. Time-stamped HD video. Multiple angles. No staging.

We delivered the footage with a neutral, factual report — no commentary, no conclusions. The carrier's SIU team and counsel made the call from there. The claim was resolved, and the carrier avoided a six-figure long-term payout.

What made this case work wasn't aggressive tactics. It was patience, lawful methods, and rigorous documentation. Done right, fraud investigations protect honest claimants too — by keeping premiums and program integrity intact.

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