Fraudulent workers comp claims

Owning a business has many different perks: making your own hours, watching your ideas in action, and many more. But there are also some things that may not be the most fun when you are the boss. Once such thing is when you suspect an employee may be lying about an injury at work.

The best thing to do is follow all the protocol as you normally would, but with a watchful eye. Some red flags that may indicate fraud has been attempted are:

  • Your employee reports his claim on a Monday stating that his injury occurred first thing Monday morning or late Friday night.
  • The alleged injury occurred right before a strike was supposed to start or immediately after it ends.
  • The alleged injury occurred before job termination or at the end of a season for seasonal workers.
  • The doctors used by the claimant have a history of suspicious claims.
  • No witnesses are available to come forth about the claim.
  • The claimant’s account of the incident is different than the first report of injury.
  • The claimant has a history of workers comp claims that also raised red flags.
  • The claimant does not want to go for diagnostic testing to determine the exact injury.

Of course it is in your best interest to voice your suspicions to your workers comp carrier so that a thorough investigation can be completed. Insurance fraud costs the American public and business owners close to $80 billion each year according to the Coalition Against Insurance Fraud. Preventing fraud whenever we can will help keep insurance premium costs down and help eliminate the need to increase prices elsewhere as well.

Call us to find out more about how insurance fraud can affect your business. We can tell you everything your carrier does to stay on top of insurance fraud and keep your premium as low as they possibly can in the process.