workers building a wall

5 Ways Employers Can Prevent Fraudulent Claims

There are some things you can’t prevent or predict, but you can reduce your risk of becoming the target of fraudulent claims in several ways:

1.) Close Communication

  • If you talk to your employees about the risks of filing fraudulent claims–for them legally, and for the entire security of the business and their coworker’s jobs–they will be less likely to pursue those kinds of claims. Make sure you make your zero-tolerance policy on fraud very clear, and also make sure all employees know that they can report fraud anonymously.

2.) Drug Testing

  • One of the most common reasons employees file fraudulent claims is to access prescription medications to which they are addicted. If you detect opiate use in an employee, they’re likely to seek pain medication. Furthermore, drug users are typically more desperate and unreliable than non-drug users, and a positive drug test could be a helpful red flag.

3.) Careful Hiring

  • Keep an eye out for employees with a history of job-hopping, especially if they work in industrial or manufacturing positions where employees typically stay for many years. Furthermore, trust your gut and the feelings of other coworkers; typically, if someone is just looking for an easy payout they won’t work very hard or seem like they’re trying to create good, lasting rapports.

4.) Surveillance

  • Installing video cameras in areas where workers are likely to claim injury (such as loading docks or anywhere ladders are used) is a great way of heading off false claims.

5.) Create a Supportive Working Environment

  • Typically, employees are more likely to file fraudulent claims against employers they don’t know or do know and dislike. They feel like they’re “sticking it to the man,” but if you actually foster a good relationship with workers and create a work environment where everyone is mutually invested in the success of the company, your employees are far less likely to take you for a ride. Sincere employee loyalty is the best insurance against worker fraud.

Of course, if you’re an employer who’s already been the victim of a fraudulent claim, what you need to do now is fight it! Call us at Stop Claims to talk about your options.

patient with walker shaking hands with doctor

Top 5 Warning Signs of a Falsified Injury

Falsified personal injury claims—they’re not a victimless crime. Injury claims hurt businesses in terms of insurance premiums, moral, and reputation. If you’re an employer who’s concerned that one of your employees may be falsely filing for workers’ compensation due to a work-related “injury,” follow your gut and investigate. Here are a few of the warning signs that you might have a case of fraud on your hands.

1.) No Insurance

Though less common since the Affordable Care Act, many people do not have any health insurance. If you have temporary employees, part-time employees, or workers on a 1099 or contract basis, and do not offer them health insurance through your business, it’s quite possible that they’re uninsured. If they sustain an injury on their own time, they might falsely claim it occurred while at work so they won’t have to bear the cost of their medical treatment themselves.

2.) Difficult to Diagnose

Broken bones, lesions, bruising—these kinds of injuries can’t be faked. If your employee is complaining of pain that can’t be definitively diagnosed, however, it might be a fabrication. Soft tissue damage is a the most common injury fraud complaint, because it can’t be verified with an X-Ray or MRI, and relies only on the employee describing symptoms that can easily be researched online. Joint pain or head and neck injuries are also very common, and also easy to fake if you’re willing to do a little acting.

3.) No Witnesses

If there were no witnesses to an injury, it could be a red flag for a false claim, especially if that employee is usually working in the company of others. There aren’t many employees who can find a coworker willing to lie for them, risking their job and potential perjury charges, so most fraudulent claims are solo acts. If there is a witness, make sure their stories match up, and that you take their statements separately and possibly more than once.

4.) Monday Accidents

Mondays are the most popular day of the week for fraudulent injuries. Most employees spend their weekday evenings having dinner, watching television, or otherwise winding down, and usually save more active tasks or entertainment for the weekend. They might be cleaning their gutters, dancing the night away, or going on a ski trip—and if they get hurt, don’t be surprised if they come in the next day and claim it happened on the clock.

5.) Repeat Offenders

37 percent of the people who file injury claims file again—these statistics don’t add up! Though it’s possible that someone might injure themselves a second time if the dangers in an unsafe work environment are not addressed after the first claim was filed, it’s also possible that you have a professional liability fraudster on your hands. Be especially wary of a second claim if you already felt like the first claim was suspect and you believe that you’ve fostered a safe environment.

If any of these red flags remind you of an injury claim filed against your business, call us at Stop Claims! We’ll help you investigate the claim, set the record straight, and keep your insurance premiums low.