Compensation Fraud

Compensation fraud has become a nightmare for businesses but a fishing spot for dishonest workers. Unfortunately, the menace is affecting overall organizational success. The complex investigation process and claim-related expenses are financially draining, while the tainted reputation pushes potential investors and shareholders away. 

Fortunately, businesses and organizations have found several ways to curb workers’ compensation fraud, including partnering with insurance companies who specialize in this area. Here are 4 tips for employers when handling worker’s compensation claims.  

Educate Employees about Workers’ Compensation

During the hiring orientation or regular meetings, educating employees about their workers’ compensation rights protects them from misleading information. They are less likely to commit fraud or abuse the system since they already know every fine detail. 

During the meetings, let your employees know you understand how compensation fraud happens and are ready to safeguard your business. Be firm, make your zero-tolerance stance on fraud known, and emphasize how everyone loses once fraud occurs. Make it clear how the actions reduce their chances of getting a reward or other incentives and hinder organizational growth.

Consider inviting a reputable insurance company to explain the injury or illness reporting process and when to file a claim. The move will make them feel protected and valued. Also, the assurance from an expert of accurate benefits in case of a workplace injury or illness will immensely aid in fraud elimination.

Conduct Thorough Job Recruitment Processes 

Your recruitment process should have excellent screening systems to fish out possible untrustworthy employees. Be very deliberate and check out their criminal background. Also, contact their references, especially previous employers, and enquire about any history of suspicious injury claims.  

Additionally, frame your questions during the interview to determine their integrity levels. Listen to how they answer and look out for red flags, as they will likely reveal their true colors. For instance, ask them the steps they would take if they disagreed with some of the management policies.

Investigate Workplace Incidents

Investigate an incident thoroughly immediately after it happens, as the injured and witness memories are still fresh. Talk to them separately and gather as much information as possible about what transpired. Also, review your surveillance camera footage, verify the witnesses’ statements, and look for inconsistencies. Thorough investigation helps point out suspicious details and prevents possible compensation fraud. 

Moreover, the comprehensive evaluation also aids in getting to the root cause and preventing future incidences. You can teach your employees valuable injury-prevention mechanisms through safety-related training and keep everyone, including your business, from trouble.

Establish Proper Incident Reporting Procedures

Consider establishing a flawless fraud-reporting system for employees to report fraud. Have open communication, such as regular meetings or question and answer sessions, and allow everyone to speak freely and transparently about fraud.  Also, encourage employees to report workers’ compensation fraud through open dialogue, emails, employee newsletters, or posters. Incorporate anonymous reporting to their work compensation carrier if they are not comfortable speaking out. 

Also, have a dedicated work compensation carrier unit for thorough investigations of fraud cases. The unit should also provide information and assistance to the injured employee to avoid misunderstandings.  

Conclusion

Investigating and prosecuting workers’ compensation fraud is very expensive, thus leaving a huge financial burden on the business. However, organizations can prevent these fraudulent cases by educating employees, having proper fraud reporting channels, investigating incidents thoroughly, and screening job applicants.   

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