Unwitnessed accidents

Delay in notification of injury

Injury near a strike, layoff, termination, or right after hiring

Claimant immediately gets attorney

Hostility, reluctance to provide information,  address (PO Box), phone, medical records

History of time off the same time of year

History of filing repeated claims

Monday morning claims: claimant has an early Monday morning accident (injury may have occurred off the job over the weekend)

Being put on probation for poor job performance

Recent conflicts with supervisor or coworkers

Suggestion from medical sources that a closer look at claimant is needed

Claimant cannot be reached because he or she is never home or is reportedly sleeping and cannot be disturbed

Repeatedly rescheduling, cancelling, or not attending scheduled medical appointments and/or physical therapy.

Anonymous call from outside source or tips from co-workers

Conflicting descriptions of the accident/incident between employer’s report and initial medical evaluation

Claim is filed immediately before or after a holiday

Accident occurs in an area where the claimant would not usually work

Family member or known friend recently receiving a comp settlement

Doctor(s) cannot find a reason for continued pain

Others in the claimant’s department involved in comp claims

Alleged injury relates to a pre-existing injury or health problem

Claimant being denied time off from work and then reporting a claim

Claimant known to have significant hobbies outside work and there is upcoming event

Recent family changes, especially a recent divorce

Claimant is experiencing financial difficulties

Any recent criminal or civil charges filed against claimant

Claimant has extensive medical knowledge or has extensive insurance terminology; however, no training in the medical or insurance field.

Adjuster intuition