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AOE or COE Insurance Investigation

Employees in America suffer workplace injuries everyday, but often, employees try to con employers into paying for injuries that actually took place outside of work. It is the job of an AOE/COE Insurance Investigation to determine if the injury being claimed through workman’s compensation was actually sustained at work.



AOE (Arriving out of Employment) and COE (Course of Employment) insurance investigations are commonly employed by companies to determine the validity and severity of a workman’s compensation claim. Clients in need of an AOE/COE Insurance Investigation may include:

  • Insurance companies
  • Businesses receiving workman’s compensation claims
  • Anyone who needs to verify a workplace injury

Employees in America suffer workplace injuries everyday, but often, employees try to con employers into paying for injuries that actually took place outside of work. It is the job of an AOE/COE Insurance Investigation to determine if the injury being claimed through workman’s compensation was actually sustained at work. For example, an employee may pull a ligament on a weekend ski trip, but they do not want to pay for medical treatment or do not have health insurance, so they decide to hide the injury until Monday morning, then “suddenly” injure themselves at work.

During an AOE/COE investigation, private investigators will speak to witnesses of the injury, review any video footage of the accident, analyze the scene of the accident to determine the likelihood that the injury occurred in the manner reported, and review medical reports to verify the timeline reported by the employee. Information collected by a private investigator can provide a date and time for the injury reported, determine any inconsistencies in the employee’s story, and employee surveillance to verify the severity of the claim. For instance, to make sure that an employee claiming severe back pains is not doing back flips off the diving board at home on the weekends.

It is important to start an AOE/COE Insurance Investigation as soon after a claim is filed as possible to make be certain that witnesses and the claimant are interviewed before they have had time to forget what they saw, or receive training from a workman’s compensation lawyer. Other evidence of the accident can disappear as quickly as people’s memories, especially when the injury takes place in a public area or when blood is involved, which is why a thorough investigation immediately after the injury is so important.

Businesses and insurance companies pay out huge sums of money every year in false and fraudulent workman’s compensation claims, which drives up costs and severely hinders a company’s ability to remain competitive in a weakened economy. Falling victim to AOE or COE insurance claims can ruin even the healthiest companies, and can be devastating to small, independently owned businesses. Do not allow your company to be taken advantage of by petty thieves and con artists; investigate every suspicious work injury claim.


(2/20/2013)
ICS World TV

Case Type Difficulty

Effort:

Typical Investigation

Duration:

3-14 Days

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