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Annie Hayes

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HR sleuthing: Detecting bogus sickness claims

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HR managers are increasingly cautious of how to treat employees that claim long-term sickness; some employees may abuse the system and act dishonestly, others are sincere so how can you separate the fibbers from those in need?


It is a common misunderstanding that private detectives are the world of movies and betrayed housewives. This couldn’t be further from the truth. The insurance investigation industry is becoming a highly specialized area employing well trained and skilled detectives working for both employers and insurers.

The hardest time of the year brings out the worst in people
For many, January is a hard month to get through. The glitz and glamour of Christmas is over and summer is a long way away, which unfortunately brings out the worst in people. Dishonesty comes in many forms and can include fabricated accident claims, which then often translates into a long term sickness claim. Research shows that investigations into dishonest claims are more successful in January than in any other month.

The growing number of long-term sickness claims is not always covering for holidays. It is often found that such spurious claims are made to hide the fact that the individual is actually undertaking casual paid employment elsewhere.

The building trade, haulage contractors and most of the labouring forms of employment suffer most. Claims of sickness are common and indeed so are short and better paid contracts in these areas of employment.

However, employers who are not in need of this type of workforce should not become complacent. Cleaners working nights on double pay, barmen standing in for a holidaying friend and even a ladies hairdresser setting up her own shop on the benefits of sick pay are all common offenders.

The use of a commercial, private detective agency is not a fanciful idea just for the movies. It can be an effective method of exposing false claims of sickness or, on the other hand, to confirm that an employee is actually ill.

How does it work?
Understanding how an investigation works is important. The investigators themselves need to be subtle but persistent in their approach to avoid upsetting honest employees.

With high speed cars and hidden cameras, surveillance operatives are there to fight ‘fire with fire’. They are trained in Court procedures and filmed exhibit production. An effective surveillance exercise involves interchanging vehicles and pedestrian personnel – necessary to get a clear film of the subject.

Following any investigation, the employee will receive a written report detailing every aspect witnessed and the film obtained corroborating this. Legally, the content cannot be disputed and the operatives cannot be accused of bias to their client as, of course, the camera does not lie. It is important to note that filmed evidence is often used in Court or at an Employment Tribunal, whatever the circumstances.

Finding specialists
Appointing the right person for the job is paramount. An advert in the Yellow Pages cannot detail the expertise and professionalism needed to carry out this type of work in a sensitive and respectful manner. It can be a minefield of inexperience, shady operations and inflated fees.

  • Ask for proof of experience – being a former police officer is not good enough

  • Ask to see the surveillance vehicles, cameras etc.

  • Request to see a prepared report – even a specimen affidavit of evidence

  • Finally, ask for references. Nothing is better than word of mouth in this business

Any reputable company will welcome you to their offices. Many, not so reputable, work out of a back bedroom. You would interview new staff so do not be embarrassed to interview any service provider.

Investigating your employees is a sensitive matter and it should be handled professionally and on well-grounded indications that something might be inaccurate. However, healthy suspicion might save your company a lot of money. If employers have a suspicion today they have a legal option to know for sure.

Over the last 12 months there has been filmed evidence of paraplegics playing golf, relatives stealing from each other and even the employee of the month, working covertly for a competitor. Expect more of the same in 2006 and be on your guard in January.

Stephen Hayes is an independent surveillance consultant at Quantum Enquiries and Surveillance.

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Annie Hayes

Editor

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