When a carrier suspected a long-standing workers' compensation claimant was submitting fabricated medical records from a physician in Rhodes, Greece, they turned to Delta Group to find the truth. What followed was an international investigation that proved geography is no barrier to exposing fraud.
The Red Flags
The claimant had been receiving workers' compensation benefit payments since the 1990s. During a routine review, the carrier made a troubling discovery: one of the medical providers listed on the claim had died in 2018, yet documentation bearing that provider's name continued to surface.
That revelation cast serious doubt on every piece of supporting evidence, including medical records purportedly from a treating physician in Rhodes, Greece. The carrier needed to know whether those records were legitimate. The only way to know for certain was to go there.
Sending an Investigator to the Source
Delta Group deployed an international investigator to Rhodes to conduct an on-site verification. The mission was clear: confirm whether the claimant had actually received recent treatment from the named physician, identify any potential collusion between the claimant and the doctor, authenticate the submitted medical documentation, and gather court-ready evidence to support potential litigation.
The assignment required persistence. The investigator made multiple visits to the medical facility before successfully securing a face-to-face appointment with the treating physician. Navigating international medical privacy considerations and building the rapport necessary to conduct an effective interview demanded both cultural sensitivity and seasoned investigative expertise.
What the Doctor Said
When the investigator placed the submitted medical documents in front of the treating physician, his reaction was immediate, and definitive.
The doctor confirmed he had not seen the claimant in several years, directly contradicting the submitted records claiming recent treatment. He verified that the handwriting on the documents was not his own. The medical facility stamp appearing on the paperwork was fraudulent. And the physician was so disturbed by the fraudulent use of his name and professional credentials that he is considering taking independent legal action against the claimant.
The doctor provided a signed affidavit documenting all of these findings, delivering precisely the kind of defensible, court-ready evidence the carrier needed.
The Outcome
The investigation conclusively exposed a fraud scheme spanning multiple years and involving multiple fabricated providers. With the signed affidavit and supporting documentation in hand, the carrier was positioned to pursue recovery, terminate improper benefit payments, and move forward with litigation.
The financial exposure involved was in the multi-millions based on decades of potentially fraudulent benefit payments that had gone unchallenged until a boots-on-the-ground investigation finally revealed the truth.
Why This Case Matters
Sophisticated fraud doesn't always announce itself. It builds layer by layer, document by document, sometimes over decades. When a claimant is willing to submit records from a deceased provider, it's reasonable to question everything else in the file.
This case is a reminder that some investigations require more than database searches or document review. They require experienced investigators willing to go the distance.
Delta Group's network of trusted international partners means our clients are never limited by geography when it comes to validating claims, verifying medical treatment, or exposing fraud. When the evidence leads abroad, we follow.
Ready to make an assignment? Contact Delta Group atreferrals@deltagroup.net or call (800) 329-4143.
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