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Fraud Diagnostic Module
The diagnostic phase includes weighted
questions in 10 categories such as accident
circumstances, applicant’s claim reporting,
response to your initial investigations,
medical treatment profile, and legal
representation. If the claim is ripe
for fraud investigation, you instruct
us to go to step 2. This process can
also help identify third parties and
circumstances that that call for worker
compensation subrogation. |
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FREE for a limited time: To access Tristar’s exclusive Fraud Evaluator Program, register here. |
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Background Check
This stage of worker compensation fraud
investigation includes the claimant’s
history (prior incidents of personal
injury claims, workers’ comp, and/or
other legal disputes); confirmation of
addresses, Social Security number, vehicles
and other factors. Only after this do
we proceed to step 3. |
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Field Assessment
We spend up to two days in the field performing
pre-surveillance site research, activity
checks and on site subrosa. Are there
are any immediate signs of fraud? Is
the claimant active? Do neighbors have
tips? This final stage of worker compensation
investigation gives you with the data
to decide if additional subrosa investigation
is indicated. |
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