Thank you for sharing!

Your article was successfully shared with the contacts you provided.

A rather typical business story became a head-scratcher of a Workers’ Comp claim — and an illustration of the power of predictive modeling — when a seemingly “normal” claim was flagged for potential fraud.

A person traveling for business stayed in a hotel, as many people do when they travel, but with a twist. He filed a Workers’ Compensation claim for supposedly suffering an injury after falling off a chair in his room. According to the claimant, he could no longer work, but he didn’t expect that a predictive modeling tool would flag his case based on his occupation and other factors, bringing it to the attention of the insurer’s Special Investigations Unit (SIU).

Want to continue reading?
Become a Free
PropertyCasualty360 Digital Reader.


  • All PropertyCasualty360.com news coverage, best practices, and in-depth analysis.
  • Educational webcasts, resources from industry leaders, and informative newsletters.
  • Other award-winning websites including BenefitsPRO.com and ThinkAdvisor.com.

Already have an account?



Join PropertyCasualty360

Don’t miss crucial news and insights you need to make informed decisions for your P&C insurance business. Join PropertyCasualty360.com now!

  • Unlimited access to PropertyCasualty360.com - your roadmap to thriving in a disrupted environment
  • Access to other award-winning ALM websites including BenefitsPRO.com, ThinkAdvisor.com and Law.com
  • Exclusive discounts on PropertyCasualty360, National Underwriter, Claims and ALM events

Already have an account? Sign In Now
Join PropertyCasualty360

Copyright © 2021 ALM Media Properties, LLC. All Rights Reserved.