Continuing its position as an industry leader in fighting work comp insurance fraud, ICW Group’s Special Investigations Unit recently presented at the 38th Combined Claims Conference in Garden Grove, Calif. The conference attracts hundreds of claims-related professionals for two days of topical sessions. ICW Group’s session was titled Intersection of Workers’ Compensation and Fraud.
Attendees learned the definition of fraud (the intentional deception or misrepresentation to obtain undeserved benefits) and the acronym for spotting it, M.I.L.K. (Material, Intent, Lie, and Knowledge).
The presentation also covered a wide range of topics, including several steps employers can consider implementing as part of a holistic approach to detecting, deterring, and defeating work comp insurance fraud. Here are the steps we shared:
Reporting Suspicions (SPOT IT & STOP IT!)—Foster an open environment where employees feel comfortable discussing concerns and reporting suspicious activities.
Training Programs—Prevention through education is a great way to combat ever-evolving fraud schemes proactively. Current ICW Group customers can visit our Policyholder Center for more information on how ICW Group can partner with you to educate your employees regarding workers’ compensation fraud schemes and their impact on your business.
Culture—Create and reinforce a comprehensive safety culture throughout the organization. Promote a culture of honesty and integrity through ethics training and clear communication of company values.
Technology—Implement appropriate tools, such as video surveillance, vehicle GPS/cameras, and access controls, to dissuade suspect claims and validate legitimate claims.
Robust internal controls to help prevent fraud
- Ensure segregation of duties. No single employee should have control over all aspects of a financial transaction. This reduces the risk of fraudulent activities going undetected.
- Be sure to conduct regular audits. Conducting regular internal and external audits helps identify discrepancies and enforce accountability.
Put in place thorough verification processes
- Strengthen identity verification processes to prevent fraud through the use of fake or stolen identities.
- Conduct thorough background checks on new hires, especially those in sensitive positions.
A critical aspect of any successful anti-fraud program is collaboration and communication between employers and their insurers. At ICW Group, we are ready to partner with you to detect, deter, and defeat insurance fraud.
