Fraud Solutions (SWAT)

The SWAT Team — Fraud Solutions

Every business has sustained losses resulting from workers’ compensation fraud and abuse. Reports have shown that fraud costs the insurance industry $5 billion each year. That is why we have a proven and effective SWAT Team,  a specialized unit designed to identify and prevent suspicious/illegitimate claims from developing into large claims.

Recognizing Fraud — Common Red Flags:

  • The person filing the claim is not reachable at home or by phone
  • Their address is a post office box or the person has moved out of state
  • The injury coincides with layoff, termination or business closing
  • There are no witnesses to the accident
  • The person filing the claim has a prior history of filing
  • Injury is inconsistent with activity at the time of injury

The SWAT team uses the following tools to combat suspicious/fraudulent claims:

  • Extensive background and social medical checks
  • Early coordination with case managers and supervisors to implement focused surveillance and independent medical exams where needed
  • Consultations with legal team on heavily litigated files to prepare our strategy for hearings
  • Conference calls with lay witnesses on claims that involve employer testimony

The SWAT team has successfully secured $6 million in reductions as a result of this process.

To learn more about how our SWAT Team or to report a fraudulent claim please contact Michael Peragine, 914-694-6000, Ext. 205 or Dan Stangarone 914-694-6000, Ext. 241.

The Friedlander Group’s workers’ compensation program helped us a great deal with saving our clients money. Their service and responsiveness exceeded our expectations and further solidified our relationships with our valued customers. Their safety groups helped our agency get into several new prospects and generate new accounts at the same time locked out all competition.