Claim concerns. Clear findings.
WSIB Fraud Investigations
Discreet WSIB investigations to examine claim concerns and give employers and their advisers a clear account of the facts.
Start with the question that needs answering
A Careful Review of a Claim Concern
WSIB investigations can help when specific information about a workplace compensation matter needs clarification. You may have conflicting accounts of an incident, questions about reported activity or records that do not appear to align.
At Facts Investigations, we review the concern before recommending work. We then agree on the inquiries that may help establish the facts. You receive documented findings to help your team assess the concern and decide on the next step.
Questions that may call for further inquiry
Issues We Can Discuss in WSIB Investigations
Each file needs its own assessment. The examples below describe concerns to examine, rather than conclusions about a worker or the validity of a claim.
Reported Activity & Restrictions
You may have specific information that appears inconsistent with reported restrictions. We can discuss whether observation would help clarify it. We record the activity and its context for your claims or legal adviser to review alongside the wider information.
Circumstances of an Incident
Accounts may differ about where, when or how an injury occurred. Relevant records and witness inquiries may help clarify those differences. We first identify the disputed facts and the information already available.
Other Work or Business Activity
A concern may involve employment or business activity that appears absent from the information on file. We assess relevant inquiries and document what they show. Your adviser can then consider any reporting or benefit implications.
Billing & Service Questions
Questions about whether a billed service took place may require further factual review. We discuss the records and authority available before accepting the work. The assignment must remain within the access and scope agreed.
Supporting Records & Timelines
Dates, reports or other records may contain discrepancies that need explanation. We can review material you are authorized to provide and identify factual gaps. Medical interpretation remains a matter for the appropriate health professional.
Conflicting Witness Accounts
People may recall an incident differently or hold information missing from the initial account. We can help locate relevant witnesses and document their statements. An account is assessed alongside the other available information.
A separate concern about workplace theft, property damage or other business misconduct may require a different assignment. Our corporate investigation services cover related business inquiries.
Methods selected for the specific issue
How We Carry Out WSIB Investigations
We choose the proposed work around the question and available information. A file may call for one focused inquiry or a combination of research, interviews and observation.
Relevant Background Research
We review appropriate background information and available records connected to the concern. This may include relevant public online material. We also consider dates, identity and source reliability before treating a result as useful to the file.
Witness & Incident Inquiries
We assess leads about people who may have seen an incident or hold relevant information. Interviews, statements and suitable site inquiries may then help clarify the circumstances. The record distinguishes personal observations from information repeated by others.
Surveillance & Field Observations
Where appropriate, discreet surveillance may document relevant activity through notes, photographs or video. We agree on the objective before fieldwork begins. The account includes the times, locations and relevant details of the activity observed.
For WSIB investigations, privacy, lawful access and the purpose of the inquiry shape the work. We confirm the instructions and any required permissions before proceeding.
A defined brief and a clear record
Plan the Work Around the Missing Facts
Effective WSIB investigations begin with a specific concern and a realistic scope. We discuss the priorities and reporting needs so you understand what the assignment can address.
Review the Concern
First, explain the discrepancy, the timeline and the information you hold. We also discuss the locations involved and any instructions from your legal or claims adviser.
Agree on the Inquiries
Next, we discuss the proposed methods, budget and communication arrangements. Once the scope is agreed, we carry out the work and document relevant findings.
Assess the Findings
Finally, we explain the results and what remains unresolved. You and your adviser can then review the information and consider whether any further inquiry is needed.
Context matters as much as the observation
Reporting That Separates Facts From Inference
WSIB investigations should produce a clear account of the work, including information that supports or challenges the concern. We discuss how the report and supporting material will be provided.
Our Role and the WSIB’s Role
Facts Investigations is an independent private agency. We gather and explain information for your review; the Workplace Safety and Insurance Board remains responsible for benefit decisions.
Recorded Work and Observations
Relevant dates, locations, inquiries and activity documented during the agreed assignment.
Material Behind the Findings
Statements, relevant records, photographs or video obtained within the scope, where available and appropriate.
Context and Useful Follow-Up
Gaps in coverage, uncertain information and matters that require professional interpretation or further inquiry.
Discretion and an objective approach
Discuss Your WSIB Matter With Our Team
Facts Investigations is a licensed Ontario private investigation agency, founded in 2012 and based in Mississauga. We assist employers and their advisers with sensitive factual inquiries.
We listen to the concern before proposing WSIB investigations. That conversation helps define useful work and gives you an opportunity to ask about scope, updates and reporting.
Learn about our agency and our director.
Before an assignment begins
Common Questions About WSIB Investigations
Find out how an assignment is planned, what to prepare and how costs are agreed. Select a question below to read more.
What do WSIB investigations involve?
They involve factual inquiries about a concern connected to a workplace compensation matter. The work may include reviewing records, locating witnesses or documenting relevant activity. We discuss the question first, then propose methods suited to the circumstances.
How do you assess a concern about a claim?
We start with the specific discrepancy, the available records and the question you need answered. Then we assess which inquiries could clarify the facts. The findings give you an objective basis for reviewing the concern.
How can surveillance help with a claim review?
Surveillance can record visible activity during the period observed. The notes and media provide a factual record for review. Health professionals and the appropriate decision-makers assess what the observations mean alongside the wider information.
What should an employer prepare before contacting you?
Prepare a brief timeline, the specific inconsistency and the relevant locations. Also identify which records you are authorized to provide and who will give instructions. We can then discuss what further details are needed without collecting unrelated personal information.
Can you coordinate with our lawyer or claims representative?
Yes. Tell us who is authorized to instruct us and receive the findings. We can discuss the questions they need addressed, the reporting format and any deadlines. Your adviser remains responsible for advice about the claim or employment decisions.
How much does an investigation cost, and how long does it take?
Rates typically range from $75-$150+ per hour, depending on the scope and complexity, plus any applicable expenses needed to carry out the assignment. First, we review the concern and available information. Then we discuss a proposed budget and schedule. We agree on priorities and useful observation periods to make the best use of the planned work.
Can we report suspected fraud directly to the WSIB?
Yes. The WSIB provides an official channel for reporting concerns. Our work can help gather and organize relevant facts when you need more information about a concern. See the WSIB’s fraud-reporting information for current reporting options and information about confidentiality.
How can our adviser use the report?
The report provides a factual account of the agreed inquiries, with supporting material where collected. The WSIB makes decisions within its authority, while your legal or claims adviser can discuss how to submit or use the information.
Learn more about our agency
Take a Look at Our Brochure
Get to know about us, the services we offer, and the areas we serve.
Which Part of the Claim Needs Clarification?
Tell us the concern and the facts behind it. We can discuss whether WSIB investigations are suitable and what information would help define the work.
Call +1 (416) 655-3106