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Ferreting Out Workers' Comp Fraud

Special Report: ENTERPRISE: IN BOX


Do you suspect that one of your employees is milking a supposedly work-related injury for all it's worth? There are many ways to identify possible workers' compensation fraud, according to the National Insurance Crime Bureau, which is prosecuting employees for this transgression in record numbers this year. The NICB, funded by insurers, works with police departments to investigate property-casualty insurance fraud. Consider it a red flag if the injured worker:

-- Reports that the accident occurred in the early morning, especially on a Monday. It may be a sports-related or weekend injury claimed as having happened at work.

-- Says the injury occurred in an area where he or she wouldn't normally be (especially if it's a high-risk area), or if no one witnessed the accident.

-- Is facing financial pressures or anticipates disruption in pay due to an impending strike or looming layoffs.

-- Has a history of short-term employment or lied on the original job application.

-- Changes doctors several times while undergoing treatment for the injury.

-- Takes off more work days than the reported accident would seem to warrant.

-- Retains legal representation immediately after the accident has occurred.EDITED BY AMEY STONE

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