Stryker Investigation Services Inc.
Our Investigation Services
What we do
Multiline Insurance, Property, Casualty, Life and Health Investigative Services
Stryker’s insurance fraud services include Workers’ Compensation (Workers’ Comp) insurance fraud, surveillance, AOE/COE statements, and subrogation investigations, employer-level investigations, litigation interviews, and statements (SIU) anti-fraud program.
Stryker Investigations’ battle-tested insurance defense services encompass all aspects of insurance investigations, Workers’ Compensation, activity checks, surveillance, subrogation, AOE/COE statements, and fraud investigations. We provide insurance defense services to insurance carriers, third-party administrators, law firms, municipalities, and employers from the private sector. Every investigation is unique, and there is no one-size-fits-all approach regarding Activity Checks, Surveillance, Subrogation, AOE/COE Statements, and fraud Investigations.
We work directly with examiners, attorneys, and management to conduct services around specific client requests, service instructions, or significant claim activity. Each investigation is tailored toward the unique needs of a particular client and designed on a case-by-case basis to uncover the nature and extent of the deception and expose fraudulent and/or abusive claims.
We provide multi-line insurance claim investigations that are battle-tested insurance defense services. These services include Workers’ Compensation Subrosa surveillance, 4-hour activity checks, home care and hospice caregiver integrity investigations, employer-level accident investigation AOE/COE statements from the claimant and witnesses, subrogation investigations to identify responsible parties, property owners, individuals, or entities involved and fraud investigation focused on suspicious claims, surveillance; as well as, other insurance-related investigation requests. We provide insurance defense services to insurance carriers, third-party administrators, law firms, municipalities, and employers from the private sector.
SUBROSA SURVEILLANCE
Workers’ Comp Surveillance
Our clients normally request multi-day surveillance or daily monitoring for workers’ comp. We also provide a 4-hour activity check, fixed surveillance, and other surveillance services for insurance companies. We clearly understand what it takes to provide actionable information to expose exaggerated and patently false claims. We provide tailor-made surveillance investigation solutions; our investigators are trained to carry out various assignments at locations throughout the US.
AOE/COE INVESTIGATIONS
Recorded Statements
The cause of the injury must be determined in order to process a workers’ compensation claim. Our on-the-job injury investigations include every possible detail about the accident scene, any recreational injuries, occupational diseases, and other unusual circumstances. Every investigation report has the same basic objective, find facts known to be true, gather the best available evidence with the least possible delay, and make determinations or recommendations for administrative disposition.
SUBROGATION
Third-Party Negligence
The purpose of subrogation is to place responsibility for the injury where it belongs. Subrogation is your opportunity to conduct a causal investigation and identify property owners, individuals, responsible parties, or entities involved. Determine any contributing factors and establish if there is any contributory negligence, immediate cause, intervening cause, proximate cause, or proximate consequence and establish any negligence. Subrogation arises from either an overt act or omission by another party.
ALIVE & WELL CHECK
Current Health Status
We can validate your claimant’s current health status, medical treatment, and present address with an “Alive and Well Check” and ensure the claimant is, in fact, alive and well and they are receiving benefits. Our investigator will ask for verification of employment or disability status, social security number and date of birth verification, telephone number, spouse and children information, and photographs of the claimant at his residence. Our investigator also inquires about the subject’s day-to-day activities, and how their property and home are being maintained, and we determine their next of kin’s contact information.
An alive and well check takes about 5 minutes. Often times the insurance carrier will contact the injured worker and/or his attorney and ask to meet in order to complete the alive and well check. At the time of the meeting, they will ask the claimant to fill out an affidavit certifying that they are receiving their checks and they are not working.
CAREGIVER FRAUD
Caregiver and Hospice Fraud
Caregiver integrity investigations. Do you suspect Caregiver Fraud? Do you suspect caregivers are not arriving as scheduled at the patient’s residence? Do you suspect the caregiver of billing for the time they were not providing care? Do you suspect neglect, poor conditions, elder abuse, the theft of Rx medications, or missed treatments? A licensed private investigator can conduct surveillance to confirm that caregivers adhere to their schedules and best practices.
Billing patients or insurance companies for services that were never provided;Padded” insurance claims that include actual services that were rendered along with additional or extra services that were never provided;Upcoding” – charging patients or insurance carriers for services and procedures that are much more expensive than the services provided.
ONSITE CANVASS
Accident/ Medical/Pharmacy
ACCIDENT SCENE CANVASS: We can conduct onsite accident inspections and canvass to find witnesses, fixed security camera locations, point of impact debris, measure skid marks, and provide the Insurer with the information needed to evaluate the claim.
MEDICAL CANVASS: Medical canvassing (at counsel or insurer’s request) involves a private investigator identifying an area and canvassing small doctor’s offices, specialists’ offices, hospitals, laboratories, pharmacies, clinics, urgent care facilities, etc. Then acquire about the subject’s presence in those locations. Successful medical canvassing can uncover undisclosed pre-existing medical conditions that occurred outside the scope of employment, addictions, or a pattern of drug-seeking behavior, discover undisclosed treatments, or material misrepresentations about the claim, and provide the insurers with an accurate assessment of the Claimant’s motivations treatment and behavior.
License Investigation Agency Since 2000
Stryker Investigation Services Inc. Licensed Investigation Agency
WORKERS’ COMPENSATION CLAIMS INVESTIGATIONS, FRAUD, SIU AND INSURANCE-RELATED SERVICES
We recognize fraud occurs in simple and complex schemes of intentional misrepresentation or concealment. Unlike errors or mistakes, fraud is deliberate and maybe intentionally hidden. For this reason, we use creative strategies to determine the presence of deception, which is intended to achieve financial or personal gain at the expense of a victim. Every investigation is unique, and there is no one-size-fits-all approach. We work directly with the examiners, attorneys, and management to conduct the services around a key or significant claim activity. Each insurance investigation is tailored toward the unique needs of a particular client and designed on a case-by-case basis to uncover the nature and extent of the deception and expose fraudulent and/or abusive claims.
Everyone should have immediate access to expert investigative resources to help with their insurance defense and mitigate insurance claims and other suspect insurance transactions. Stryker provides on-demand investigative expertise and consultations. Our areas of focus for the insurance investigation program are Workers’ Compensation (Workers’ Comp) Liability AOE/COE, Surveillance, Subrogation investigations, and (SIU) anti-fraud program. We have a clear understanding of what it takes to provide actionable information to expose exaggerated and patently false claims. Our sophisticated insurance investigations are a tried-and-true defense designed to identify potentially fraudulent and/or abusive claims. Should surveillance be necessary or requested. Stryker will work directly with the examiners and management to conduct the services around a key or significant claim activity.
WARNING SIGNS OF WORKERS’ COMPENSATION FRAUD / RED FLAGS
Lying about or misrepresenting your injury to claim Workers’ Compensation benefits is considered Workers’ Compensation Fraud. One in Ten Workers’ Compensation Claims in California is fraudulent. Every year millions of dollars of taxpayer money are being claimed by people who do not work, and those who get injured are facing undeserved hardships. After a Workers’ Compensation Claim is filed, there are a few things that are straight red flags for the workers’ compensation insurance companies:
1. There are no witnesses who can corroborate the Claimant’s injury.
2. Employee’s refusal to undergo medical diagnosis.
3. Inconsistencies in the employee’s description of the incident.
4. The employee is hard to reach while he is ‘out injured.’
5. The employee has filed for a claim just after being terminated.
6. The Claimant has a history of numerous suspicious or litigated claims.
SOME OF OUR REGULAR CLIENTS
