Workers’ compensation fraud costs American employers millions of dollars a year. The most publicized form of the fraud involves bogus claims by workers.  This fraud can be prevented or detected with some awareness and skepticism.

Employee-perpetrated scams

The vast majority of workers’ compensation claims are valid. However, when claims aren’t valid, it can be a costly headache for employers.

To uncover possible workers’ comp fraud perpetrated by employees, look for certain anomalies — for example, accidents with no witnesses, or incidents that occur just before an anticipated strike, layoff or termination. Also regard with suspicion an injury that isn’t consistent with the nature of the employee’s position or your business, or if the worker:

  • Can’t recall specifics about the injury or accident,
  • Refuses or delays diagnostic procedures,
  • Is never home or is reported to be sleeping and unable to be disturbed, or
  • Moves out of state.

It may be possible to expose worker-initiated scams simply by interviewing fellow employees or paying unannounced visits to the injured employee’s home.

Abuse means higher costs

It’s in your company’s interest to prevent the kind of abuse that increases the cost of workers’ comp coverage. If you need help getting to the bottom of suspected fraud activities, contact us.