How to Spot Cases of Workers’ Comp Fraud

How to Spot Cases of Workers’ Comp Fraud

In the United States each year, employees file approximately $7 billion worth of fraudulent workers’ compensation claims against their employers. In fact, in the insurance industry, one in every four fraudulent claims is related to workers’ comp. If you own a small business, it’s essential that you protect yourself from fraudulent workers’ comp claims.

The signs of fraudulent workers’ comp are pretty easy to spot, especially if you know what you’re looking for. Oftentimes, an employee who files a fraudulent workers’ comp claim is not a first-time offender. If you are suspicious that a person might be lying, check out his or her history. If he or she has filed a claim in the past, it is highly likely that they are lying now.

If the employee typically works in a crowded workspace, but the injury happened when there were no witnesses around who can corroborate his or her story, the claim may be fraudulent. Many people who file false claims choose a time when no one else is around for their “injury” to occur.

It’s important to pay attention to the timing of the injury, as well. If the employee reports an injury on a Monday, it’s likely that the injury actually happened over the weekend. Ask your other employees if there were signs that the employee was in distress or discomfort before the injury occurred.

If you think that one of your employees is lying about being injured on the job and is seeking workers’ compensation, you should report it to your state’s workers’ compensation fraud investigation department immediately.  If you need help finding out for sure whether you’ve been the victim of fraud, give us a call first.

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