false workers compensation claims
false workers compensation claims

clock February 24, 2020

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How to Spot and Prevent False Workers’ Compensation Claims

The United States recorded an incidence rate of 2.8 workplace-related injuries per 100 full-time workers in 2018. The Bureau of Labor Statistics notes that these figures have reduced steadily since the year 2010. Even so, there have been concerns that there could be many more cases that go unreported each year.  

From an employer’s point of view, dealing with employee complaints is a complex process. Such complaints eventually lead to compensation claims, which cost your company money. But how do you ensure that your staff members don’t lodge false workers compensation claims?  

Well, if you’re not careful, you may end up honoring false employee reparation claims from unscrupulous personnel. Here’s an employer’s guide on how to spot and prevent false employee claims. 

1. Hire Carefully

Are you keen on preventing any occurrences of false claims in your workplace? Well, it must start at the recruitment stage. You must conduct a thorough background check of each potential recruit before hiring.

If you get it right at the recruitment stage, you’ll be good to go. Records of past complaints are available and can be accessible for your perusal, but keep in mind that you have to follow ADA policies about workers’ comp. If an employee had complained in the past, there’s always a chance they may do it again.

Further, if an individual has had a fraud conviction in the past, you may need to be extra vigilant before committing to hiring them. While such past incidences do not define an individual in totality, it’s essential to consider the possibility of such history being a reflection of the future.  

2. Foster a Fraud-Free Environment 

If you already have a workforce in place, there may be a challenge when it comes to considering background checks as the basis for employee retention. But all is not lost, though. You may consider fostering a fraud-free work setting through continuous discourse.

One of the best ways to address the misconceptions around false compensation claims is to talk about the issue. Let your employees engage you in what they consider to be false versus genuine compensation claims. Once you are clear about the issue, let your staff know the consequences of such actions. 

Such conversations will ensure that you nurture a culture of transparency among your staff. It would help if you also encouraged other staff to speak out in case of suspected attempts to defraud the company by their colleagues.  Such an approach is critical for an honest work environment. 

3. Install CCTVs Within and Around the Premise

Video equipment at the workplace is not only meant to address the security concern. You can also use such installations to help you keep track of employee activities within the work setting. How do you ensure that your employees don’t claim compensation for an injury they sustained outside the workplace?

Well, this may be hard if you don’t have a surveillance system to keep your employees in check. Video assessment on CCTVs can help you keep track of all the activities inside the workplace. Such recordings can be crucial if an employee lodges a phony claim.

4. Develop a Clear Action Plan in Case of Injury 

The problem with many organizations is the lack of a clear roadmap on what to do in case of an injury. Failing to plan will get you in trouble eventually. You ought to develop a master plan on how a worker should report an injury once it occurs.  

Such stipulations include how long after an injury an official claim can be made. You should be clear on the designated office where all complaints should be lodged. This approach ensures that there’s a well-structured reporting mechanism within the organization. 

Further, you may need to set a witness standard, where a claim needs to be supported by a specific number of witnesses for it to be valid. With such structures, it is easy to determine if an application is fraudulent or genuine and avoid making false compensations.

5. The Devil Is in the Details

As an employer, you need to check out for possible red flags. While a job jumper may have their reasons for being a rolling moss, it may also be a sign of a potential false workers compensation claims suspect.

If you discover that an employee has had an extensive criminal record that is not work-related, you may need to probe further. You may also need to listen to co-workers and pay attention to their thoughts and skepticism about colleagues.

These small details may change your view on your employees and their susceptibility to fraud. Essentially, it may be presumed unfair to judge your employees on such a basis. Even so, it’s better to focus on due diligence and be wrong rather than give such employees the benefit of the doubt only to be disappointed.

6. Have a Worker’s Compensation Plan 

Once you have done everything necessary to ensure there are limited loopholes for false claims in your organization, the next step is to look for reliable workers’ compensation insurance framework. You need to ensure that your business is insured from the uncertainty of work-related injuries by consulting worker compensation specialists

You may have your misgivings about a specific claim. Such concerns are typical, especially in cases where you have many employees. If your worker compensation insurance is in jeopardy, it would help to consider the assistance of compensation specialists.

Signs of False Workers Compensation Claims

There are a few indicators you may consider when deciding on whether a claim is false. The most common is scanty information about the cause and exact time an injury occurred. Further, if the application is not supported by evidence, you may have your reservations on its genuineness.

You also need to pay attention when a claim is made several days after an injury. For most organizations, claims that are made on a Monday morning are considered subject to investigation. While you may not get it right all the time, being on high alert will save you from fraudulent employees.

Not All Claims of Injury Warrant Compensation

More companies are falling prey to fraudulent employees out to swindle employers. Before you process a request for work-related injuries, you may need to conduct thorough background checks. Such checks will ensure that you don’t fall victim to false workers compensation claims.

But in case of genuine injuries, our agents are on hand to offer you the best advice on worker compensation. 

Is your worker compensation insurance structure in jeopardy? Contact us for a lasting solution.

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