Detecting Red Flags for Workers Comp Claims

Detecting Red Flags for Workers Comp ClaimsNot only is Lake Tahoe Workers’ Compensation fraud illegal, it adversely affects the insurance carriers and the honest businesses who pay for premiums. While the majority of claims are, in fact, legitimate, employers need to be weary of the following red flags. Therefore, here is a comprehensive list of the common factors that are typically present in workers’ compensation fraud.

Oftentimes, the injury in question occurs on a Friday afternoon or first thing Monday morning. Especially if the employee failed to report the injury until the following Monday, this is can be cause for suspicion.

Next, if the employee in question has a track record of changing/inconsistent employment, this could be a cause for concern. According to Property Casualty 360, this means that the reported accident occurs immediately before or after a strike, job termination, layoff, end of a big project, or the conclusion of seasonal work. If the employee has a long history of reporting claims, this could raise red flags, as well.

If there are no witnesses to the accident and the employee’s description of the accident does not make logical sense, this might be cause for concern. Furthermore, if the accident report and medical records tell a different story from the employee’s recount, it could possible signal fraud.

Lastly, keep an eye out for claimants who are hard to reach, refuse treatment, or use specific doctors and lawyers each time they file a workers’ compensation claim.

While none of these singly-occurring components guarantee potentially fraudulent activity, the combination of two or more should raise red flags for you as the employer. By identifying these common warning signs, you can protect your business’ bottom line, avoid increased premiums, and ensure your employees are legitimate.

At Cal-Nevada Insurance Agency, we understand the importance of securing your workplace. By protecting your business and your employees with our comprehensive and custom tailored coverage, you can rest assured you are properly defended. For more information about our other business lines, contact us today at (866) 670-5948.

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