Our Special Investigations Unit (SIU) saves policyholders millions of dollars in questionable claims costs each year by investigating injured workers, employers and medical providers suspected of workers' compensation fraud.
This type of fraud includes working while collecting benefits and making false medical statements in order to receive benefits.
This costs all employers. Not only does it give some employers an unfair advantage, but it also affects the premium rates all employers pay. Examples of employer fraud include underreporting payroll, misrepresenting the nature or volume of a company's business and altering certificates of insurance.
This occurs when a provider charges for visits, care or treatment that wasn't given to the injured worker. Falsifying patient information is another example of medical provider fraud.
• A new employee files a claim
• An injured worker hires an attorney the day of the accident
• The accident story changes often
• There is a long delay between the accident and the filing of the claim
• The claim coincides with a layoff or termination
*It should be noted that the above could occur in the normal course of business and may not necessarily be an indicator of fraud.
If you hire subcontractors, make sure their Certificate of Insurance is valid. The best way to do this is to get it directly from the issuer — which could be us, one of our affiliated insurance agents or another carrier.
Explore more workers’ comp resources.
