PREMIUM FRAUD
Premium losses by carriers are increasing
Work with premium audit and underwriting units
Assisted with millions in additional premium owed & collected
Premium Fraud is increasingly costing carrier’s larger premium losses. When employers misrepresent their company either by; payroll, employee count, types of services provided or hiding legitimate workers’ compensation claims, the amount of premium lost becomes significant.
California is one state where it is becoming harder for employers to operate a profitable business. Some employers result to cheating carriers out of higher premiums they should be paying. Reasons can include; it can be seen by an employer as a “victimless” crime, able to bid jobs lower than their competitors while maximizing profits, sheer greed or all the above.
Helping carriers recoup this loss from suspect employers is one of our specialties. Our investigators work hand in hand with Premium Audit and Underwriting Units of carriers to build successful premium fraud cases for law enforcement. These types of cases help an SIU become a profit center for the carrier. Employers don’t want to lose their business and by paying the additional premium that is owed immediately, may save themselves from jail time.
Comprehensive strategies and techniques are in place for our clients to maximize the information gathered by our field investigators. Information obtained from the field is shared across our departments with SIU oversight to cross-reference claims data. Our competitors don’t utilize the above and beyond strategy to identify areas of potential premium fraud or assist in ongoing provider fraud investigations. These techniques utilized by our investigators, the comprehensive proactive strategies and integration of information across all departments, was born from our staff’s national carrier industry experience. This is what makes ArgusFirst an industry leader for investigations, cost containment and having a significant impact on overall claim costs. When adding ArgusFirst as your SIU partner, the often elusive and/or dismissive term by many in the industry of “SIU as a profit-center” is now a reality.
