After a large claim is filed, many contractors can’t help but question its authenticity. Hopefully, your construction company has a robust safety program in place and your Safety Director has a good rapport with your construction workers, so this doesn’t fall into question. The reality is workers’ compensation fraud can occur in any construction company. This continues to be a growing concern for the industry.
It’s imperative to have preventive tools in place while also being aware of this serious concern. Here’s the story of a contractor who suspected workers’ compensation fraud:
A large asphalt paving, excavating, and concrete contractor in the Midwest detected workers’ compensation claims they feared were illegitimate. Like many contractors, they place a high priority on employee safety and are always in their employees’ corner. The desire to ensure fairness to all parties is always on the forefront when exploring these claims.
The contractor identified five specific workers’ compensation cases that were potentially fraudulent. All accidents were clearly legitimate at the time of injury. However, the recovery periods and values of those losses didn’t align with other similar cases. They engaged an attorney with expertise in workers’ compensation fraud cases to strategize a plan of action. After thorough research by legal advisors and third-party administrators, they were able to make a case against the numerous questionable claims and secure rulings in their favor based on the state’s workers’ compensation fraud statue. The result was $3.2 million in savings.
The contractor then developed a plan to take the savings gained by eliminating fraudulent claims and give back to their employees through investing in health and wellness initiatives.
Here are some signs to look out for if you believe an employee is committing workers’ compensations fraud:
• Monday morning injuries – When the alleged injury occurs on a Monday morning, this could mean the injury occurred over the weekend.
• No witnesses – If no one witnessed the accident occur, there’s a chance the employee could be falsifying the incident.
• Contradictory descriptions – If the employee’s story of the incident changes each time, there’s reason to be concerned about the truth of the incident.
Contact an MMA advisor for more information on workers’ compensation fraud in construction.
