🚩 10 Red Flags Employers Should Watch For to Prevent Workplace and Insurance Fraud

Fraudulent workplace or insurance claims are a costly problem for businesses. They can increase premiums, drain resources, and disrupt operations, sometimes costing thousands or more. Being able to identify potential warning signs early is essential for protecting your company.

In this post, we’ll highlight 10 key red flags employers should watch for, and explain how you can take action if you suspect fraudulent activity.

1. Injury Claims with No Witnesses

Claims without witnesses or supporting details can be a warning sign. Vague descriptions of accidents make it difficult to verify legitimacy. Always document incidents carefully and look for inconsistencies.

2. Monday Morning Injuries

Injuries reported right after weekends may indicate incidents occurring outside the workplace. Monitor patterns in reporting to spot suspicious trends.

3. Conflicting Medical Information

Medical notes that don’t match the reported injury, or show signs of alteration, may signal dishonesty. Cross-check documentation and involve professionals if needed.

4. Inconsistent Recovery Behavior

If an employee claims limited mobility at work but is observed performing physically demanding tasks elsewhere, it may warrant closer scrutiny.

5. Frequent or Repeat Claims

Multiple claims from the same employee over time can indicate a pattern of potential abuse. Tracking claims history is important for risk assessment.

6. Reluctance to Provide Details

Employees who avoid questions or change their story frequently can create red flags. Encourage transparency and document all communications.

7. Tips from Coworkers

Other staff may notice suspicious activity. Maintain open communication channels and consider employee reports seriously.

8. Extended Absences Without Updates

Delays in providing required medical or claim documentation can be a warning sign. Consistent follow-up and proper documentation help identify potential issues.

9. Exaggerated Restrictions

When claimed limitations don’t match observed abilities, it may indicate deception. Use professional assessments to confirm the facts.

10. Financial or Disciplinary Stress

Employees facing personal financial difficulties or recent workplace discipline may have higher motivation to commit fraud. Awareness and careful monitoring can mitigate risks.

✅ Taking Action

If one or more of these red flags appear in your workplace, it’s time to take a closer look. First Recon provides discreet, professional investigations to confirm the facts and protect your business from fraudulent claims.

We help employers:

• Verify the legitimacy of WSIB and insurance claims

• Conduct surveillance and evidence collection

• Provide professional, court-ready reports

• Reduce unnecessary costs and prevent future fraud

Don’t wait until fraud affects your bottom line. Contact us today to safeguard your company.