What is Workers’ Compensation Fraud?
Most of the time, workers’ compensation fraud is highlighted when an employee exaggerates their injuries or falsifies medical reports to gain unlawful benefits out of the employer’s workers’ compensation insurance policy. However, workers’ compensation fraud is conducted in a few other ways as well. Sometimes, the guilty party is the employer, the insurance adjuster, or a healthcare provider. For example, the employer may underreport payrolls or categorize full-time workers as part-time independent contractors to qualify for a cheaper insurance premium or outright deny a claim.
Similarly, the insurer may undermine a genuine claim to minimize or avoid payout. Some healthcare providers also try to mint money by charging extra or billing claimants for treatment they never received. The person who suffers the most from workers’ compensation fraud is the employer, whether they are themselves responsible or have been deceived by a claimant/third party. New York City Employment Attorney has helped many employers deal with and resolve cases of workers’ compensation fraud.
The following measures will facilitate the purpose of preventing Workers’ Compensation fraud within your establishment:
1. Work with a Reliable Insurer
When choosing a business insurer, opt for one that holds a commendable market reputation. Do not liaise with a company with suspicious history just because their insurance premiums are cheaper. Many businesses suffer because of bad faith insurers, and you don’t want to be one of them.
2. Hire a Business Lawyer
Many businesses fail to cope with fraudulent claims and lawsuits because they are unequipped at the legal front. Their paperwork is ineffective, management lacks investigative skills, and their insurance policy is inadequate. Partnering with a business lawyer from the start helps eliminate such discrepancies.
3. Implement the state’s health and safety standards
Abiding by health and safety standards helps maintain a safe and nourishing workplace environment. When working conditions are topnotch, employees are unlikely to formulate schemes to deceit the employer. It will also become increasingly difficult to stage an accident and fake injuries.
4. Screen new Recruits
Whenever the company is hiring new staff, thorough background checks are vital to the selection process. Candidates with a history of involvement in civil disputes can be problematic.
5. Develop a healthy relationship with the staff
Treat your staff like family, so that they consider themselves an important part of your organization. Employers who eagerly participate in projects and discussions at all levels are appreciated. Getting to know your employees and allowing them to communicate with you directly encourages loyalty.
6. Designate a trustworthy Medical Examiner for personal injury claims
In order to avoid being conned by notorious medical practitioners and institutions, establish a partnership with one you can trust. All workers’ compensation claimants should be obliged to consult the specified medical examiner to qualify for reimbursement.
7. Keep an eye on Claimants
Workers who claim to be severely injured or ill should be scrutinized. For example, you can send someone to check upon them at their home. You can also track their location and keep in touch through calls to make sure that they are not using their time off for the wrong reasons or vacationing.
8. Effective surveillance at the workplace
Surveillance cameras covering every square meter of the workplace also plays an important role in preventing fraudulent activity. Whenever an accident happens, you can go through the surveillance footage to determine its seriousness and discover if it was deliberate sabotage.
9. Establish a zero-tolerance policy against fraud
If you set out strict rules and regulations regarding fraud and unprofessional practices at work from the start, you will minimize the likelihood of legal disputes in the long run.
10. Institute a competent HR team
Since the HR team is responsible to deal with complaints and claims, the members should be able to distinguish between truth and lies. They must possess the skill and experience to look into these matters and evaluate their shortcomings.
