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Worker's Comp in Texas

MarylandMaryland 1 Post
in FMLA/ADA/Workers’ Comp Vote Up0Vote Down
Is it ok to use a third party to invesitgate suspicious worker's comp claims? The insurance company should do this, but can we do more? Thanks.
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  • 2 Comments sorted by Votes Date Added
  • Don DDon D 9,834 Posts
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    You can 'investigate' anything you want to investigate, with or without a third party. However, depending on your particular state's laws and comp laws, you may run into prohibited activities such as surveilling people with the use of tape or film, stalking, etc. Call your state's comp commission state office and they will advise you.
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  • J MackJ Mack 14 Posts
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    As I am sure you are aware, in Texas we remain 1 of 2 states that allow employers to choose to subscribe or not subscribe to W/C. For subscribers, the employer is somewhat out of the picture once a claim has been filed. While you and I both would agree that the insurance carrier would surely encourage input from the employer, as a rule, that doesn't happen. My experience is that the carrier would appreciate "additional" information you could provide related to the facts of the alleged claim. And, it is not uncommon at all for the carrier to undertake investigative measures if they become suspicious. If you have knowledge of Claimant's activity that you believe your carrier should know, I would certainly contact them. As with non-subscribers, anything the employer can do to manage the claim to a quick conclusion they should do. In our state Non-subscribers have a lot of flexibility that subscribers do not have. But, there are risks to consider.
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