Client Access | Workers’ Compensation Fraud

We’ve all seen the statistics, Workers’ Compensation fraud continues to rise. It’s estimated that 10% of all claims involve some form of fraud or benefit abuse. That translates into nearly $34 billion dollars paid annually for fraudulent Workers’ Compensation claims. Obviously, the best way to control costs is to control the number of claims with a strong safety program. However, when injuries do occur, company-wide fraud awareness helps to reduce dollars spent unnecessarily.

Three Steps for Reducing Fraud

Step 1 – Create a written policy regarding fraud

  • Have written policies and procedures that make it clear to employees you will not tolerate any abuse of the workers’ compensation system.

Step 2 - Post Signs

  • Post signs throughout your organization about fraud awareness and how employees can report fraud. Employees are an excellent source for detecting fraud.

Step 3 – Educate your employees

  • Train your staff on how to detect fraud and how to report it.
    (See: Fraud Indicators)
  • Hold meetings and include topics on fraud and its impact on the financial health of the company. Let them know the harm that fraud causes them and the company.
  • Make sure your Workers’ Compensation carrier claim unit has procedures for investigating, prosecuting, and seeking recovery from overpayment, or benefits received fraudulently.
  • Report any suspected fraud immediately. The earlier the claims representative is aware of potential fraud, the better the opportunity of detection.

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