Workers’ compensation claim appeared inconsistent with reported injury - insurer needed objective documentation

A State Farm-referred workers’ compensation claim involved a claimant reporting severe physical limitations that had prevented them from returning to work for eleven months. The reported limitations were inconsistent with information available to the adjuster, but the carrier lacked the documented evidence necessary to formally challenge the claim.

Workers’ compensation fraud investigations require more than a hunch. The evidence must be time-stamped, continuous, and documented to a standard that withstands legal challenge. A single observation on a single day rarely meets that threshold.

Watson PI conducted three sub-rosa video surveillance sessions on non-consecutive days across a two-week period. Each session documented physical activity directly inconsistent with the claimant’s reported limitations. Documentation included date, time, location, and continuous unedited video footage. A formal written report was prepared and submitted to the carrier in the format required for claims review proceedings.

The documentation was submitted to the carrier’s claims team and subsequently used in the formal claims challenge process. The claim was successfully challenged. The carrier’s regional adjuster noted in a follow-up communication that the documentation was among the clearest sub-rosa evidence they had received on a contested claim.