A Restaurant Owner’s Guide to Sub Rosa Investigations

Author: Gene Immendorf

Sub rosa investigations are valuable in the workers’ compensation industry, providing documented evidence and information unavailable elsewhere. However, the process is often flawed, with inadequate assignments, poorly planned investigations, and no plans for using the information to achieve improved outcomes.

 

What is Sub Rosa For?

Sub rosa investigations aim to obtain evidence of an injured worker’s activities and abilities, helping to refute or confirm subjective complaints. ‘Sub rosa’ literally means the sign of the rose – to be quiet and not seen. It’s about discreetly observing an individual’s activities to uncover the truth behind their claims. A successful investigation can provide visual proof of daily activities, employment status, and potential fraud.

The sub rosa industry has undergone significant changes in recent years, driven by technological advances. The widespread use of social media, GPS tracking, and digital surveillance tools has transformed how investigations are conducted. However, despite these advances, the fundamental principles of sub rosa remain the same. It’s still about getting the truth—uncovering evidence that can make or break a case.

 

Recognizing the Need for Sub Rosa

Now, we have more tools to achieve that goal, but not everyone’s approach to sub rosa has kept pace with these technological advancements. Restaurant owners should know that some insurance companies or claims administrators may still use outdated methods, leading to poor results.

Many red flags indicate the need for sub rosa. Some include excessive subjective complaints, unnecessary assistive devices, and information from the employer, treating physicians, or defense attorneys. The referral should contain all relevant information, including red flags, subjective complaints, and scheduled medical/legal appointments. Restaurant owners can advocate for thorough investigations by being vigilant about these signs.

 

The Investigation Process

A professional investigation agency will conduct a thorough review, including social media analysis and identifying potential surveillance targets. The investigator will provide a written report, video evidence, and photographic documentation while complying with privacy laws.

Many sub rosa assignments are inadequate, often resulting in poorly planned and executed investigations. As a sub rosa vendor and expert in the field, I have seen firsthand the common complaints that plague our industry. These complaints include:

• Inadequate assignments with insufficient information
• Poorly planned investigations with unrealistic expectations
• Limited budgets and restrictive instructions
• A focus on verifying investigator hours rather than ensuring a thorough investigation
• Misuse of sub rosa investigations as a checkbox exercise rather than a valuable tool
• Lack of understanding of the purpose and proper execution of sub rosa investigations

These complaints are from insurance companies, clients, and sub-rosa vendors like myself, who are frustrated with how our services are utilized. For restaurant owners, it’s essential to communicate these concerns to your insurance agency to ensure a more effective process.

 

Making Sub Rosa Effective for Restaurant Owners

Conducting two to three consecutive days of surveillance is often necessary to gather valuable information and photographic evidence. This approach ensures that the individual under surveillance will be observed conducting their daily activities. As a restaurant owner, you can request this thorough approach from your insurance adjuster when a claim is filed.

The workers’ compensation industry often misuses sub-rosa investigations, prioritizing cost containment over effective results. Carriers focus on verifying investigator hours rather than ensuring a thorough investigation, undermining the value of sub-rosa investigations.

I’ve witnessed this firsthand in my work. For instance, I once followed a sheriff who claimed to be completely incapacitated. Despite her claims, I caught her working out at a gym—lifting weights and engaged in rigorous training. This example highlights the need for thorough investigations and underscores the potential for significant fraud, demonstrating how crucial these investigations can be for protecting your restaurant from fraudulent claims.

Let’s step back and remember what sub rosa is all about. It’s about getting the truth, about uncovering evidence that can make or break a case. It’s not about checking boxes or verifying hours. It’s about results. As a restaurant owner, you can help ensure that sub rosa is used effectively by communicating with your insurance providers about your expectations.

So, let’s make a change. Let’s start using sub rosa like it’s meant to be used. Let’s make it a valuable tool again. Our industry deserves better. Our clients deserve better. Let’s get back to basics and make sub rosa mean something again.

Ensure your workers’ compensation process is effective and efficient. Contact CRMBC today to learn how we can help you safeguard your business. Get Started Now!