10 Steps to Workers’ Comp Fraud Prevention

Fraudulent claims can cost your business money, tarnish your company’s reputation, and damage employee morale. ICW Group’s Special Investigations Unit offers these 10 steps to help prevent fraudulent workers’ comp claims.

  1. Know who you hire – A strained labor market has made good hires even harder to come by. Conduct as much vetting as possible. Thoroughly interview job candidates to spot red flags and ensure they aren’t a bad apple in waiting. Got questions about hiring? Reach out to ICW Group’s human resources experts at HR OnDemand® for help.
  2. Educate – Protocols and procedures reinforce that your workplace is a well-run machine. It’s equally important that your employees understand the benefits available to them, including the difference between workers’ compensation, disability, and health insurance offerings.
  3. Manager Training – An injured employee’s complaints may fall on deaf ears if your leaders don’t know what to listen for. Supervisors and managers should understand the work comp process, including investigating safety lapses for appropriate correction and who to notify when an injury happens. Refer to ICW Group’s anti-fraud training series to up your management’s fraud awareness game.
  4. Zero Tolerance – Do your employees know that fraud will be prosecuted? They should. Use ICW Group’s suite of anti-fraud messaging materials to navigate this sometimes-tricky topic and help your employees understand the severity of false claims.
  5. Safety, Safety, Safety – Reoccurring and topical safety meetings avoid injuries from ever happening. They also reinforce to your staff that you care about their well-being. This goes a very long way in avoiding what I like to call disgruntled employee syndrome. ICW Group’s online resource, Safety OnDemand®, offers up a wealth of safety training topics for your use to help avoid job injuries. Also, contact your Risk Management Consultant for a one-on-one consultation.
  6. Listen – Don’t ignore complaints of poor working conditions or broken tools and equipment. Employee morale is maintained by feeling heard. To drive the message home, fix the issue, and then let them know that you appreciate their dedication to a safe work environment for everyone.
  7. Security Cameras – Cameras are inexpensive, sophisticated, and indispensable when trying to understand how a work injury may have occurred. Security cameras are a strong deterrent to would-be fraudsters.
  8. Investigate Injuries – We’ll do the fraud investigation if it comes to that but be sure to investigate how an injury occurred. You’re well served to dust off those safety detective skills to ensure that you gather all of the facts and ultimately understand how the injury could be avoided in the future. Need a place to start, check out ICW Group’s accident investigation resources.
  9. Care – If one of your team members is unfortunately injured at work and requires medical attention, show them you care by regularly checking in on them. Most claims are wholly legitimate. Chances are they want to get back on their feet and return to work just as much as you want them to. Support them now to strengthen that loyalty bond for years to come. Show them you care with a personalized e-card, and by helping them navigate the work comp claim process.
  10. Exit Interviews – As workers expand their job horizons, you may lose some. Take advantage of exit interviews to gain their departing perspective and rule out any yet-reported ailments.

Fraud defense starts well before the claim is filed. With these ten steps, you will be showing your employees tangible proof that you are on the same team, mutually invested in their safety and success for many years to come.

Christopher Dill
Christopher Dill
Christopher Dill is the Special Investigations Unit Director at ICW Group Insurance Company. A Fraud Claims Law Specialist designee, he was a recipient of the National Health Care Anti-Fraud Association’s Investigation of the Year Award for his significant contribution to the successful resolution of “Operation Back Lash” – one of the largest workers’ compensation health care bribery schemes ever uncovered in San Diego County. Christopher has participated in over 30 criminal cases surrounding medical and legal providers attempting to defraud the Workers’ Compensation system. Christopher’s approach to insurance fraud investigations is a holistic one. From preventative education campaigns, to data analytics, to time tested investigative, and intelligence gathering techniques, it is Christopher’s belief that a multi-faceted approach to insurance fraud is necessary to a successful defense.

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