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Are they falling on purpose? A new workers’ comp fraud in NY

On Behalf of | Oct 3, 2024 | Insurance Defense |

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. Let us understand how this happens.

Elaborate scheme

According to several news outlets, workers reportedly train to stage accidents convincingly, often involving falls from ladders or makeshift staircases. Some of them even capture these incidents on video as evidence for subsequent legal claims. The workers allege severe injuries, ranging from spinal damage to permanent disabilities, even going as far as getting surgeries, for which they seek substantial compensation from property owners and construction companies.

An insurance company, Tradesmen, has filed a lawsuit in federal court, alleging widespread fraud involving construction site injuries. The insurer claims to have uncovered more than 650 fraudulent claims over the past four years, pointing to a sophisticated network of lawyers, doctors, and other medical professionals who allegedly prey on vulnerable, primarily Spanish-speaking immigrants.

Far-reaching implications

A severe consequence of this alleged scam is that insurance premiums for construction companies have skyrocketed, forcing them to increase their prices. This, in turn, leads to higher costs for homeowners and renters. Workers’ compensation settlements can run into millions of dollars, making this a lucrative enterprise for those involved in the fraud.

As this legal battle unfolds, it raises crucial questions about the vulnerabilities in the workers’ compensation system and the measures needed to protect it from abuse. It also highlights the need for increased vigilance and the importance of seeking legal advice so insurers can protect themselves from fraudulent activities.

The “falling on purpose” fraud is a glaring reminder of the challenges in maintaining the integrity of insurance systems designed to protect workers. This issue shows how important it is for everyone to act ethically and work together to keep worker protection systems trustworthy and effective.