Services
Document a loss
Support a claim
For carriers and employers
Service areas
Middle Tennessee
- Nashville
- Clarksville
- Murfreesboro
- Franklin
- Hendersonville
- Smyrna
- Spring Hill
- Gallatin
- Lebanon
- Columbia
- Brentwood
- Mount Juliet
- La Vergne
- Cookeville
East Tennessee
West Tennessee
Workers' Comp Fraud Investigation: Indicators Reported as Facts
When a workers' compensation claim raises questions, Delator Claims Division gathers the underlying facts for carriers, self-insured employers, third-party administrators and their attorneys. Indicators are reported with their sources. Whether fraud occurred is a determination for the client, its SIU or the authorities.
- Coverage
- 95 of 95 counties
- Dispatch
- 24 / 7 / 365
- Metro response
- Under 60 min avg.
- Statewide
- 4-hour guarantee
What this service covers
A red flag is not a finding. A late report, a missing witness or a prior claim can each have an innocent explanation, and most do. What a carrier needs is not an investigator's suspicion but a file in which each indicator has been run down: confirmed, explained or left open with the reason stated. Delator's investigators do that work through lawful means only, and they write the result without adjectives.
This is a carrier-side service. It is not available to injured workers or claimant attorneys. Methods are limited to observation from public places, public-records and open-source research, and voluntary interviews. Investigators do not use false identities to obtain protected information, do not trespass, do not access medical records without proper authorization and do not offer medical opinions. The report never states that a person committed fraud.
Referral triggers we commonly see
- An adjuster's checklist shows several indicators on one file and the SIU wants field verification before deciding whether to open a formal case.
- An anonymous call to the employer or carrier alleges the injury happened off the job, and the allegation needs independent corroboration or rebuttal.
- The same worker, address or phone number appears on multiple claims across different employers, and someone needs to confirm the connections.
- A claimed injury date falls on a day the employer's records suggest the worker was not scheduled, and the discrepancy needs explaining.
- A state fraud referral is being considered and counsel wants the factual basis documented by a licensed investigator first.
What the investigation covers
- Indicator-by-indicator review
- Each concern raised by the client is listed separately with the steps taken, the sources consulted and whether it was substantiated, contradicted or unresolved.
- Identity and address verification
- Confirmation through public records and field visits that names, residences and contact details on the claim correspond to real people and places.
- Court and public filings
- Civil suits, judgments, business registrations and other publicly filed records that bear on the claim history or on connections between involved parties.
- Tipster and source interviews
- Voluntary interviews with people who reported information, recording what they personally saw as distinct from what they heard from someone else.
- Off-the-job event research
- Public-source research into whether a weekend accident, sporting event or other incident near the injury date was reported or posted publicly.
- Evidence index
- A numbered list of every photograph, recording, document and web capture in the file with the date obtained and the person who obtained it.
From request to delivered record
- RequestCall dispatch or submit the request form with the location, loss type and urgency.
- DeployDispatch assigns the nearest available licensed field investigator through the statewide network.
- DocumentPhotographs, video, measurements and factual notes are captured once the scene is safe to work.
- PreserveFiles are timestamped, organized and kept in their original form with a record of who captured them.
- ReportThe package is delivered securely to the requesting party, typically the same day.
Indicators have innocent explanations too
An unwitnessed injury is common for anyone who works alone: a driver, a night stocker, a maintenance technician. A late report can reflect a worker who hoped the pain would pass. A prior claim can mean a physically demanding trade. An investigator who treats these as proof does the client a disservice, because the file will not hold up when the explanation surfaces later. Delator's reports give the explanation the same space as the indicator.
For that reason every assignment is framed as a set of questions to answer, not a theory to support. If the facts found are consistent with the worker's account, the report says that directly. Carriers use those results as readily as adverse ones: a cleared file can be paid and closed with confidence, and the adjuster's attention moves to claims where the facts do not line up.
A record that can be handed to someone else
Files that begin with an adjuster often travel to a special investigations unit, to defense counsel and occasionally to a state agency or prosecutor. Each recipient asks the same things: who obtained this, when, by what means, and was it lawful. Delator's reports answer those questions in the body of the document. Screenshots carry capture dates and addresses. Interview summaries name who was present. Video is delivered complete with its log.
Delator does not decide whether a matter should be referred to any agency and does not advise whether a claim should be denied. It does not tell a client what any statute requires of it. Those are decisions for the carrier or employer and their attorneys. If the client makes a referral, the investigator who did the fieldwork is available to explain how each item was gathered.
This service is available to insurance carriers, self-insured entities, third-party administrators and the attorneys who represent them. Delator reports facts and observed indicators; decisions on coverage, liability, settlement and any fraud referral remain with the client.
It is not offered to policyholders or claimants, and Delator does not act as a public adjuster. Policyholders and claimants can request neutral scene documentation instead.
Common questions about this service
Is this service available to injured workers or their lawyers?
No. Workers' comp fraud investigation is offered only to workers' compensation carriers, self-insured employers, third-party administrators and attorneys representing them. Injured workers and other individuals who need neutral documentation of a scene or property can ask about Delator's documentation services instead.
Will your report conclude that the claimant committed fraud?
No. The report presents facts and identifies which indicators were supported by evidence and which were not. Deciding that conduct amounts to fraud belongs to the carrier, its special investigations unit, or the authorities. Delator's investigators do not make that call and do not use that label for a person.
What methods do you refuse to use?
Investigators do not pose as someone else to obtain protected information, do not enter private property without permission, do not obtain medical, phone or financial records without proper authorization, and do not pressure anyone to talk. Interviews are voluntary and observation takes place from public areas.
Can you work alongside our SIU?
Yes. Many assignments come from an SIU that needs licensed field personnel in a part of Tennessee it cannot reach quickly. The unit sets the questions and the scope, Delator performs the fieldwork across all 95 counties, and the SIU keeps control of analysis and conclusions.
Available statewide, including
Every Tennessee county is covered. See the deployment map for typical response tiers by county.
Request documentation anywhere in Tennessee
Dispatch is staffed around the clock. For time-sensitive scenes, calling is fastest; the request form works for routine and scheduled assignments.