W.S.I.B. CLAIMS

WSIB Fraud Investigations

Workplace Safety and Insurance Board (WSIB) claims represent one of the most significant financial and operational risks employers face. While the vast majority of claims are legitimate, some employees exaggerate the severity of an injury or file a claim for an injury that did not occur, or did not occur at work. Left unchecked, this exposes employers to rising costs, higher premiums, and reputational damage. Identifying fraudulent claims requires trained investigators who can gather evidence without bias and without overstepping legal boundaries.

More and more employers are recognizing the importance of a proper workplace investigation in identifying, documenting, and preventing WSIB fraud. Determining whether an injury was genuine or staged, and whether its severity has been exaggerated, is a difficult task that requires experienced investigators working within the law.

Types of WSIB Frauds

The most commonly known frauds relating to WSIB are:

  • Exaggerating or misrepresenting the severity of an injury or illness
  • Claiming an injury is work-related when it is not
  • Submitting inaccurate or fabricated medical reports
  • Misrepresenting the cause of an accident
  • Billing for treatment or services not actually provided
  • Falsely reporting workplace theft or property damage

In Ontario, anyone conducting investigative work for hire — including WSIB claim investigations — must be licensed under the Private Security and Investigative Services Act, 2005 (PSISA). This licensing requirement exists to ensure investigations are conducted lawfully, ethically, and with proper accountability. Working with a licensed private investigator helps employers ensure a WSIB investigation is handled professionally and without bias, protecting both the company and the rights of the employee involved.

How Do We Carry Out the Investigation?

With Investigation Solution Services’ expertise, we detect the actual reason behind the claim and identify fraudulent activity. This sets us apart from other private investigation agencies. We start with a background review of the individual(s) involved to identify any relevant history, followed by discreet field visits. We then locate and interview relevant witnesses to establish an accurate account of events. Finally, we compile video and photographic evidence where appropriate, providing a clear and factual record for decision-makers.

Hiring a licensed private investigator for WSIB matters provides real support to management. Our investigators are credible, accountable, fair, and impartial. We serve corporate clients, HR managers, municipal managers, insurance adjusters, entrepreneurs, and SMEs, helping them collect the facts needed to make informed, fair decisions on WSIB claims. Investigation Solution Services is committed to protecting employers from the abuse of WSIB benefits while respecting the rights of all parties involved.