Most employers are aware that while workers’ compensation is typically a “no-fault” insurance wherein workers can get benefits even if their own negligence or mistake caused their injuries. However, there are exceptions to this rule. They include instances when...
Defending New York State Insurers And Employers
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Recognizing fraudulent workers comp claims and what to do
Workers' compensation fraud happens when someone lies about a work-related injury or accident to get money or benefits. This is a serious crime in New York State, and people who commit it can face big fines or even go to jail. What does workers' comp fraud look like?...
Are they falling on purpose? A new workers’ comp fraud in NY
A worker falling on a construction site is an unfortunate accident, but what if it is staged? According to recent reports, a troubling trend in workers' compensation insurance has emerged: deliberate falls staged by construction workers to fraudulently claim benefits....
How common is workers’ compensation fraud?
Workers’ compensation fraud is a serious concern that impacts employers, insurance companies and employees. While some believe the numbers are higher, studies and information from authorities suggest fraudulent claims account for a small percentage of the total number...
What is “light duty” after an employee files a workers’ comp claim?
There comes a time after a work-related injury that the employee’s physician will state the worker is ready to return to some work duties. Although the employee might not be ready to return to their original post and responsibilities, light duty might be an option....
There are benefits to educating employees on safety and claim reporting procedures
Educating employees on safety and claim reporting procedures is not just a regulatory formality; it's a strategic advantage. This approach can significantly lead to substantial financial savings and reputation management for your company in several ways: Enhancing...
Strategies to dispute questionable workers’ compensation claims
Despite common belief, insurance companies approve most workers' compensation claims, at least initially. Yet, the insurance company can deny the claim later on for various reasons if the insurance carrier is aware of possible later basis for denial and accepts the...
The countless consequences of workers’ comp fraud
Workers' compensation, also known as workers' comp, is a government program that provides much-needed benefits for employees who suffer injuries or illnesses due to the tasks they are performing. They receive money, healthcare benefits, or both. As with any government...
How businesses can fight workers’ comp fraud
As we have said in the past, worker’s compensation fraud costs the insurance industry and its clients $30 billion a year. It is not a victimless crime. Instead, workers who try to game the system contribute to the rising costs for all employers. Whether claim-related...
Insurance fraud often involves these groups
In the past, we've discussed that insurance fraud costs worker's compensation programs $30 billion annually in the U.S. However, the National Association of Insurance Commissioners now puts that number even higher at $34 billion ($9 billion from premium fraud; $25...