Worried About Workers Compensation Claim Fraud? Tips To Protect Your Business

Over 3 million workers suffered accidents or injuries on the job in 2013. That adds up to a lot of workers compensation claims. With so many claims being filed, it can be hard to spot any questionable ones amidst the legitimate injuries. Here are some tips to help you combat workers compensation fraud and protect both your employees and your business.

Require Management Training for Injury Response

Your managers and shift supervisors need to be aware of how to handle injury reports. Since supervisors and managers may be the first ones to find out about an accident, they need to be aware of how you expect those claims to be handled.

Your managers should be trained to spot potentially false claims and ask the right questions. There is some information that you will have to provide your insurance company after every accident. By training your managers and supervisors about the claim process and what the insurance company needs, you'll reduce errors and streamline your reporting.

Report Injuries Right Away

Once you've been notified of an injury, you need to report it to your insurance company right away. By telling your insurance company immediately, you can start the claims process and get your legal support staff involved.

This helps to expedite treatment to ensure that your injured employee has the best possible chance at getting back to work quickly. The more people you get involved from the start, the less likely it is that you'll see a fraudulent claim, because your employees will see that you're following the regulations and there's little room for sneaking through the system.

Be attentive to any claims filed early on Monday mornings, because an investigation may uncover that the accident actually occurred during the weekend. Additionally, injuries that happen when there's nobody else present are ones that should be closely investigated. Talk to your insurance company about how to weed out fraudulent soft tissue injury claims, too.

Focus on Employee Education

In addition to teaching your management staff how to handle claims, you can also spend some time educating your employees about how workers compensation works, what qualifies, and what happens when the system is abused.

Make sure that your employees understand key safety techniques and follow them. Then, stress that you have measures in place to validate claims, as this is likely to deter many would-be claimants who would try to fraudulently claim an injury. Illustrate the point that any type of fraudulent claim is a crime, and that you will ensure that the company prosecutes that crime.

Investigate Every Accident

When you receive notification of a claim, launch a complete investigation immediately. You'll want all of the information that you can get about how the injury happened and the events surrounding it. Talk to everyone who was present at the time and record statements whenever possible.

Since the details of the accident can become fuzzy over time, the sooner you get each witness to recount the events, the better. If you have any reason to suspect that the claim isn't accurate after talking to the staff, call your insurance company or lawyer from a firm like Dunnigan & Messier P.C. and ask about having a fraud investigation launched.

Your insurance company should have a team dedicated to fraud investigation. This is important, because they will be able to monitor the employee's actions, treatments and interactions to confirm that the incident was legitimate. If there is any evidence otherwise, you'll get it right away.

Always Conduct Background Checks

Your first and most important line of defense is actually an offensive one. When you are interviewing potential employees, require a thorough background check. This will tell you if the individual is trustworthy and legitimate or if the interviewee has a history of workers compensation claims and terminations. Always be cautious when it comes to hiring new staff, as they will have access to your company's information. Make sure that he or she is who you believe them to be.

With so much at stake with workers compensation claims, it's essential that you ensure that every claim is legitimate. With the tips presented here, you can help your staff understand the importance of reporting injuries as well as the risks of reporting a false claim. Your workers compensation rates can be affected by your claim history, making this information important to your company's bottom line.