Fraud in Workers’ Comp

May 18, 2016

One of the best ways for businesses to control their workers’ compensation costs is to control the frequency of all insurance claims. There are legitimate claims however; unfortunately, there are also fraudulent claims. In addition to a well-planned safety program, your business should also address a zero tolerance for fraud as standard policy. The following tips can strengthen the front line against workers’ compensation fraud:

  • Employers should screen employees before hiring them. All information on job applications should be verified and references should be checked. Candidates who lie on applications may be more likely to commit insurance fraud.
  • All new hires should be provided with a written statement of the company’s workers’ compensation policies and a separate statement concerning safety. These should be updated at least once a year.
  • Workers should be informed that, directly or indirectly, the money for injuries ultimately comes from the employer. As they affect the bottom line, these costs inevitably impact the company’s ability to compete in the market place.
  • A fraud prevention employee exit interview should be put into place. When possible, terminated employees should sign a form attesting that they have not been injured in the work place. This reduces exposure to future claims.
  • Fraud awareness and prevention posters should be displayed in the workplace.

Workers’ compensation fraud can be identified. While the following criteria are only guidelines and are not proof of fraud, common indicators of workers’ compensation fraud include:

  • An injured worker is disgruntled or about to be fired or laid off.
  • An injured worker is in seasonal work that is about to end.
  • An injured worker takes more time off than the injury seems to warrant.
  • An injured worker is having financial difficulties.
  • An accident occurs late Friday afternoon or when the worker comes back on Monday.
  • An accident is not witnessed.
  • An accident occurs just before a strike or near the end of a probationary period.
  • Diagnosis is inconsistent with treatment.
  • An injured worker is nomadic and has a history of short-term employment.
  • An accident occurs in an area where the injured employee would not normally be found.

Let one of our licensed and experienced representatives help you and your business with Workers Compensation or other insurance need you have. Contact us today or click here to Request a Quote! We are here to work for you!

The Armstrong Company Insurance Consultants  (License #0440075)