InvestigationsWe are increasingly finding situations where we need to engage the specialist assistance of our preferred investigators, Insight Intelligence, to minimise the business and financial impacts of workers compensation claims.

Inevitably due to circumstances in the workplace, launching an investigation to gather documented evidence from a claimant, witnesses or employer is required to assist in determining appropriate liability or actions required. Investigations can be either factual or surveillance in nature.

Investigations can be internal or external and can be initiated by the employer, insurance company or related party provided there is an appropriate reason.

Often ABILITY GROUP‘s claim management process will anticipate such needs and proactively recommend investing in investigations to  accelerate outcomes and assist with aspects like determining liability, return to work, functional capability and cost minimisation.

Managing Director, Mario Bekes, and the Insight Intelligence team have specialist experience in all facets of workers compensation investigations and kindly provide the following information:

Insight Intelligence V2Factual Investigations – regardless if the investigation is internal or external, the purpose of the investigation is to not just collect evidence and to reach a conclusion but to create a better workplace practice, to implement procedures or to review current policies and procedures. The investigative report can be used as tool for reviewing and to implement policies and procedures.

When a workplace investigation is carried out correctly, it can demonstrate that the employer is committed to its objectives and fair treatment of all employees, contractors etc by using an  independent party.

For a successful investigation it is most important that the employer acts quickly by recording informally or formally statements, emails, SMS from the claimant or witnesses. The employer should record into the company log book (most probably this may be an incident/hazard notification) at the work place.

It is very important to document this information as it will reduce time spent and costs for the employer and employee in completing and reaching a conclusion of this investigation.  So once we the investigative agency are engaged or referred to commence the investigation, our investigator in charge will proceed to ask for the initial recordings of the incident or accident. This will speed up the process and reduce the investigation costs. These documents are later used as annexure together with the Report.

When we conduct an investigation, regardless if it is factual or surveillance investigation we firstly ensure that the investigator understands the scope of the investigation, we are mindful of workplace culture and performing a fair investigation (Natural Justice) with the right to be heard and the right to speak   (claimant, witnesses or employer).  During the interview process we are aware that most of the time employees are under stress and dread to be interviewed. So we always approach the interview sensitively and professionally in order to successfully complete investigation.

Surveillance Investigation – collecting evidence about the POI (person of interest) it is more of a direct approach between the employer and us the agency or the insurer that have a clear objective why surveillance should be carried out.

In order for a surveillance investigation to be successful there must be a clear objective so the investigator can plan and execute the investigation so as to minimise time and cost for the insurer/employer and to obtain documented evidence.  Ability Group will ensure that the clear objective is identified.

So how can internal or external investigation be of benefit to an organisation?

  • Ensure that supervisors, managers, employees comply with company policies and procedures, legislation/acts
  • Minimising risk or public embarrassment by reducing risk of disciplining or stop paying their benefits entitled to employee for something she/he didn’t done
  • Reducing claims costs and resulting increases in workers compensation premiums
  • Demonstration to staff of determination of commitment to fair and objective investigation/treatment
Should you want to find out more about how ABILITY GROUP, in conjunction with Insight Intelligence, can assist in reducing your workers compensation costs, please contact us to find out more.