What if you could predict which workers’ compensation claims are more likely to pose an increased risk for claim fraud, before actual fraud is suspected? Based on over 30 years of claims and investigations experience combined with the forensic science of the Fraud Triangle, we have developed a proprietary predictive analytics algorithm that enables our clients to do just that. With ForensIQ Scout, you can determine the relative fraud risk presented by each newly reported workers’ compensation claim allowing you to implement proven strategies and defend against the costly impacts of claim fraud. You can request a FREE DEMO by clicking Learn More.
ForensIQ Risk Intelligence has developed innovative protocols and initiatives that Employers can implement to deter claim fraud.
NEW! When claim fraud risk is identified, Employers can complete a risk intelligent Claims Orientation Interview with the Worker to actively reduce the identified risk and deter possible claim fraud.
Exclusively for Premium and Enterprise Members, this service, included at no additional cost, uses our INTERACTIVE ONLINE risk intelligent Claims Orientation Interview form to structure, complete and document Claims Orientation Interviews in real time. Call us today to Learn More.
No single factor can increase the opportunity risk for claim fraud more than late reporting of injuries by workers. As such, we are pleased to introduce our proprietary On Time Every Time (OTET) Injury Reporting initiative training. Employers that implement OTET initiatives are building strong claim fraud deterrence into their workplaces.
In a perfect world, fraud like all other crime would cease to exist. Unfortunately, we all realize that even with focussed attention on claim fraud deterrence, fraud may still occur. For this reason, ForensIQ Risk Intelligence offers a variety of consulting services.
Surveillance Triage: Let our experience with claims, investigations and surveillance help to guide you to the right decisions on if, when, and how to contract a surveillance investigation. We will walk you through the legal, ethical, practical and safety considerations that should all be factored in when deciding to place a worker under surveillance.
Surveillance Brokerage: With years of experience in both contracting and conducting surveillance investigations, ForensIQ Risk Intelligence can contract and manage surveillance investigations on your behalf.
Understanding Workers’ Compensation Claim Fraud in Canada
The Employers that fund Workers’ Compensation systems in Canada spend about $10 Billion annually on Workers’ Compensation claims.* 10% of the cost of claims is spent on fraudulent transactions** meaning that Employers spend $1 billion on claim fraud each and every year.
Research has found that 25% of disability insurance claims contain some element of fraud.*** In 2017, there were 761,000 Workers’ Compensation claims processed in Canada.* If one in four involved some degree of fraud then the average claim fraud resulted in $5,235 of claims costs – costs that unfairly drove up Workers’ Compensation premiums.
Why Partner With Us?
ForensIQ Risk Intelligence is your Innovative, Process Driven, Claim Fraud Risk Management Solution
The ForensIQ Process:
Step 1. Deter fraud before claims are reported. When you implement our innovative On Time Every Time (OTET) injury reporting initiative you can significantly reduce the opportunity risk associated with claim fraud. Less opportunity risk = less risk of fraud.
Step 2. Predict which claims present the greatest risk of fraud. Using ForensIQ Scout, our proprietary online predictive analytics application allows you to assess newly reported claims for their relative fraud risk. Armed with this information you will be better equipped to investigate and monitor claims and to allocate appropriate staff and resources to their management.
Step 3. Deter claim fraud by conducting risk intelligent Claims Orientation Interviews. Using ForensIQ’s proprietary online Claims Orientation Interview tools you can deter potential fraud even after fraud risk is identified. These innovative tools enable you to structure and document Claims Orientation Interviews in real-time.
Step 4. Detect claim fraud in cases where it has not successfully been deterred. For those Workers that remain undeterred and decide to attempt to defraud, ForensIQ Risk Intelligence has the solutions. Surveillance Triage and Surveillance Brokerage services will help you to detect claim fraud should it occur.
ForensIQ Risk Intelligence Empowers You To:
- Actively manage Workers’ Compensation claim fraud risk.
- Reduce Workers’ Compensation claims duration and costs.
- Reduce Workers’ Compensation premiums.
- Reduce overtime, recruiting, training, lost productivity and other indirect costs.
- Protect your investments in Health & Safety and Claims Management.
Choose the ForensIQ Membership Plan that meets your strategic claims risk management needs based on the number of Workers’ Compensation claims your organization files per year.Premium and Enterprise members receive a number of discounts and services at no additional cost.
Premium Membership paid by Monthly Instalments: Members are given several options to pay their annual membership fees, the amount due is an annual fee, and should not be treated as a monthly subscription. For members who pay their annual membership fee in monthly instalments, the entire remaining balance is due, in full, immediately upon cancellation of their membership.