Workers compensation fraud occurs when employees make a frivolous or dishonest claim regarding an injury they experienced on the job.
It's possible that employees can receive workers compensation benefits for which they should not really be eligible if they manage to persuade a judge that they should be covered for injuries. According to statistics reported by Detective Paul Colbert of Meridian Investigative Group, workers compensation fraud costs a typical consumer $900 each year due to higher costs for insurance, health care, and consumer goods.
Employers need to educate themselves about workers compensation fraud to reduce the costs of this widespread problem that affects employers in many different industries and locations. The following are three things employers should know to assist in the fight against workers comp fraud:
The most common types of fraud committed by employees
An employee can commit workers compensation fraud in a variety of ways. Even if an employee files a claim and is rightfully awarded benefits for it, he or she could still be guilty of fraud by continuing to work for another company while the benefits are being paid out.
An employee can also commit fraud by exaggerating an injury or the costs of an injury to get more workers compensation money. Other possibilities for committing fraud include filing a claim for an injury that occurred off the job or filing a claim for an injury that never actually occurred.
The warning signs
There are many different warning signs that indicate that a workers compensation claim is more likely to be fraudulent. While employers shouldn't make any assumptions regarding a claim until they investigate it sufficiently, they should nevertheless be aware of warning signs.
Employers should carefully scrutinize claims that are filed without any witnesses backing them up. They also might want to be a little more suspicious of claims that are filed by an employee with a history of filing claims or an employee who is relatively new. Also, employers should put some time into scrutinizing a claim filed by an employee who refused treatment or diagnosis for the injury in the past.
The assistance that your insurance provider can offer
The first place you should turn for assistance if you are suspicious of a claim is to your workers compensation insurance provider. Insurance providers are hit the hardest financially by fraudulent claims, so they will carefully consider your suspicions and get to the bottom of the issue. However, if you really want to protect yourself, take the time to consult with a law firm such as Kolker Law Offices PC.Share