Why Workers Comp Scam Won’t Pay?

Ask any business owner and they will tell you that insurance is not just about business general, professional and employee liability or property coverage. Generally, it is legally required for a business to receive workers compensation coverage so that employees can claim compensation when they suffer a work-related injury.

So, it’s a fact – worker composition is an important factor in any company’s insurance portfolio.

The problem is when an employee makes a false request. And unfortunately, it happens quite often. But contrary to what many believe, workers fraud not only affects businesses and their bosses and employees who lead a completely honest life, it also affects fraudsters. If you file a false workers’ compensation claim, you risk losing your job, spending time behind bars and paying expensive fines. Trust the industry: the crime – because it’s about the workers – certainly doesn’t pay!

Below you will find some examples of employees who think they can make some money while cheating the system. In the long run, the scam has turned on them.

Fake Workers Complaint Request – Real Scenarios

1. Marc worked as a gardener. One day he slipped and went to work. Marc filed a workers’ compensation claim, complaining of associated pain that rendered him unable to work any more. The process went pretty smoothly and it didn’t take long for Marc to start receiving disability benefits. But unbeknownst to Marc, the insurance company was on his trail. After watching security camera video showing Marc actively gardening for two other properties, Marc was called in. Not only would his disability checks be curtailed, he was also capped at four months in prison and ordered to pay a fine of over $39,000.

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2. Jack complained of injuries he received at work. He said the resulting back pain made it impossible for him to continue his work. Jack told the attending physician that he had not experienced any pain prior to his work injuries. It didn’t take long for insurance to provide proof that Jack lied about his inability to work. Surveillance camera caught him working as a landscape architect for the family business after his allegation, and he was sentenced to 3 years in prison and a $14,500 fine.

3. Sarah filed a workers’ compensation claim after injuring her back and leg while walking up a hill on the business’s outdoor facilities. At the time of filing, Sarah did not take into account the ability of the insurance company’s investigative department. The department’s extensive work revealed the true nature of the injuries: the injuries occurred before the date stated in the claim, and so did the discussions other employees had with him about them. Sarah was sentenced to 120 days in prison, 5 years probation and a $28,000 fine!

About Lily Hammond

I have been working as an insurance consultant in my own insurance agency since 1998. Because I've been doing this for so long, I know every detail and I'm here to help you. You can find my e-mail address and work phone on the contact page.

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