More Suspicious Workers Comp Claims
The National Insurance Crime Bureau has released a study showing that reports of suspicious workers’ compensation claims rose 24% in the first quarter of 2011 from the same period in 2010. Reports of questionable commercial claims, including slip and fall, theft, product liability and other types, increased 21%.
The study covers claims in six categories: property, casualty, commercial, workers’ compensation, vehicle and miscellaneous. Overall, insurers reported 23% more claims of potential fraud in the first quarter.
Ranney Pageler, vice president of fraud investigations for Employers Holdings Inc., a workers’ compensation insurance carrier specifically for small businesses told The Wall Street Journal that among the most common fraudulent workers’ compensation claims are those for on-the-job injuries that actually occurred elsewhere, were self-inflicted or just outright false.
Pageler, who’s investigated insurance fraud for the past 19 years, says he’s recently seen cases for the first time of employees filing false claims for medication and then selling those drugs illegally for hefty profits.
A former Los Angels deputy sheriff, Pageler urges small-business owners to make employees aware of the potential ramifications of filing false workers’ compensation claims. “Let employees know that it’s a crime and they could get into trouble,” he said.
Likewise, employees should be advised against turning a blind eye when they see colleagues abuse their health-care benefits. “If you’re working next to someone who makes a false claim, your premium will be impacted,” said Pageler.
Some warning signs, he adds, are when employees boast of having an early retirement plan just before they get injured or laid off, or when they show up to work on a Monday with an apparent injury but later claim they were hurt on the job.
A copy of the study is available at FarmEquip.org/shortlink. ◆