Tips For Reducing Your Company's Risk Of Fraudulent Worker's Compensation Claims
With hundreds of thousands of worker's compensation applications filed every year, it adds up to a lot of policy benefits being paid. In addition, with such a large number of claims filed, it can be tough to spot the ones that are questionable or falsified. Here are a few tips to help you identify fraudulent claims and protect your business from unnecessary worker's compensation premium increases.
Educate Your Employees On Worker's Compensation Policies
The first line of defense against general worker's compensation claims is a thorough understanding of safety requirements. Make sure your staff understand all of the safety procedures and follow them at all times. You can even consult a worker's compensation attorney to provide some summary information for your staff about injury and claim law.
Additionally, they need to understand what constitutes fraudulent, abusive or ineligible claims. Make sure that all of your employees understand that you have systems in place to verify the accuracy and legitimacy of all claims so that you can reduce the risk of fraudulent reporting.
Train Your Managers For Proper Injury Reporting Response
All of the members of your management and supervisory staff need to understand the proper methods for handling worker's compensation injury reports. Since your first-line managers and supervisors are often the first to hear about an accident or injury, they're the best place to start for vetting that information.
Teach your managers to ask lots of questions about the details of accidents. Find out what information your worker's compensation insurance company will want to know about each claim and ensure that your managers record those details as well. Instruct your staff to be honest if they have suspicions and ask for more clarification and evidence if required to prove the validity of the claim.
Investigate Every Injury Claim
Any time an employee files a claim notice, you'll want to launch an investigation immediately. The goal of the investigation isn't to prove the claim false but to provide clear details about what actually happened. Your insurance company will want this information, and if your employee hires a worker's compensation attorney, he or she will likely want it as well. The sooner you launch the investigation, the better your chances will be of getting accurate information, because details can become hazy over time. Record witness statements whenever possible and ask for details from every witness who saw the accident or the events leading up to it.
Be particularly cautious about any injury claims that are filed early in the day on Monday morning, because a thorough investigation may reveal that the accident actually occurred over the weekend. The same applies to injuries reported with nobody else around to witness them. Talk with your insurance company and a worker's compensation attorney about ways to identify fraud in these types of cases.
If you have any reason to question the validity of the claim after your investigation, call your insurance company and ask for a fraud specialist to evaluate the situation. This is essential, because the fraud investigation team is trained to spot falsehoods and even monitor activities for signs that an injury isn't as severe as it is claimed to be.
Report Injuries to Your Insurance Company Immediately
As soon as your staff notifies you of an injury or accident, you should reach out to your insurance company immediately. This allows them to get started on the claim while you're launching your investigation. Starting the claim immediately also helps to ensure that your injured employee is able to seek care and receive coverage for it as soon as possible.
As a business owner, it is essential that you ensure the legitimacy of every worker's compensation claim when it's filed. Not only can false worker's compensation claims cost your insurance company in settlements, they'll also cost your business in increased premiums. Protect your staff's worker's compensation benefits and your company's bottom line with these tips and the help of a workers compensation attorney and insurance carrier.
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