It's an obvious notion: economy plummets globally - fraud escalates exponentially! What makes an otherwise 'good and honest' citizen decide to defraud an employer and their insurance company, by seeking to 'unjustly' claim workers' compensation? Most people do not perceive insurance fraud as a 'crime' per-se, or would ever consider themselves as 'fraudsters'.
Fraud comes in many different forms, one of which is defined as a crime which relates to a criminal who obtains money or some other benefit or pecuniary advantage by deliberate deception.
Fraud may broadly be explained by the three components that add to the equation that allows the 'life cycle' of the crime to be committed, from inception to conclusion: 1.
A motivated offender - (What induces an offender to decide to go for it?) 2.
The availability of suitable targets - (How easy is it for claim for WC?) 3.
The absence of a fearful punishment - (What is the punishment - is it worth the risk?) Although insurance fraud is not generally perceived to be associated with a cold-hearted crime, it is an extremely costly crime nevertheless, and, contrary to popular belief, far from 'victimless'! The notion that large companies, such as exist within the health care and insurance industries, will not be influenced and suffer 'all that much' in consequence, is flawed and must be viewed in a different light, more especially nowadays.
Recent consumer research conducted on the prevailing attitude towards insurance fraud found '2 out of every 5' Americans did not see anything wrong with making a fraudulent insurance claim to acquire money to which they are patently aware they are not entitled.
In fact the notion that insurance fraud is a victimless crime is the prevailing lay-man attitude.
In reality we all become victims of this insidious crime, and end up sharing the cost.
Insurance fraud costs consumers approximately $150 billion a year in damages, leaving the average family paying a minimum of $1000 a year in higher insurance premiums and associated costs of goods and medical services, to cover the fraud generated losses.
Workers' Compensation fraud is a one of the leading contributors to insurance fraud.
Employees commit this type of fraud when they falsely claim to injure themselves at work, or when they overstate the effects of the injury being alleged.
Such fraud, in the eyes of the perpetrator, is justified in the belief that as they have 'paid' so much towards their annual premiums, they are surely 'entitled' to recover their investment in major part, regardless of - and otherwise reliant upon - the level of exaggeration that they are prepared to apply to overstate and criminalize an otherwise legitimate set of circumstances.
This is the overwhelming attitude that prevails to turn even the otherwise most law-abiding citizen, into as cunning a criminal as an armed-robber, and, in reality, perhaps even more so, because of not only the level of premeditation necessary to incept the criminal act, but their willingness to thereafter dishonestly perpetuate and exacerbate the criminal act through the process of never-ending deceptiveness, falsehood and prevarication, to include lying to all manner of professionals and even their own family and friends, who many times - and by definition - become unwittingly complicit in the commission of that crime, or otherwise a willing co-conspirator! Insurance fraud is here to stay - the economy predicates, nurtures and guarantees its growth.
Investigating this crime is our especial remit!