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Employee comp fraud the least costly

A recent poll found that employee fraud is less likely after people file disability applications, particularly in a down economy, while employer fraud tends to spike upward. These results were announced by Claims Journal’s who conducted a poll on their website which cited employee fraud ranks below employer and healthcare compensation fraud, both of which cost the system more.

According to an official with Texas Mutual Insurance Company, claimant fraud in worker’s comp is simple only because the system hasn’t been updated or changed in a number of years. “We’ve always seen the problem with the false claim,” the official stated. “The individual who is feigning injury to extend out the benefits. The one you see most frequently is what we call double dipping, or the working and drawing.”

This official went on to say, however, that while a down economy can initiate an increase in employer fraud, the opposite seems to be true for claimant or employee fraud.

“I know there was a lot of talk about when we had the financial downturn really start to hit in 2008, there was a lot of speculation that it would raise the number of fraudulent claims. Of course there was the opposite, in an economic downturn people would be trying to protect their jobs, therefore you would not see anybody who would even want to think about filing a claim, even a legitimate claim, at a time when an employer was downsizing,” said the official.

Despite speculation that the down economy would raise the number of fraudulent claims, the insurer’s numbers failed to show a change relating to workers who draw benefits but continue to work.

“We have found in the six or eight years I’ve been here, we have consistently found about the same amount of fraud and claims fraud,” said the official.

Even with the statistics from an insurance company, not all compensation fraud is black and white, nor even tangible. Make certain that if there is a discrepancy with your claim, that you have the correct legal representation for rectifying any issues there may be.

Source: 
Claims Journal, “Employee Fraud Least Costly Workers’ Comp Fraud” Denise Johnson, Sep. 12, 2013

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