How to Report Workers' Comp Insurance Fraud

Workers' compensation insurance is designed to assist injured and disabled workers incapable of returning to the job. Thousands of individuals engage in insurance fraud to take advantage of workers' comp programs at the state and national level. You can help decrease workers' comp insurance fraud by keeping an eye out for abuses among your co-workers and neighbors.

Instructions

1. Bookmark the website of your state's department of labor as you prepare to report workers' comp insurance fraud. You should pay particular attention to online forms that allow you to submit a paperless accusation against an offending party.

2. Investigate the possibility that none of your co-workers witnessed the act that caused an employee to go on workers' comp insurance. You can cast doubt on the legitimacy of a worker's claim to compensation by demonstrating the lack of corroborating witnesses.

3. Review the past disciplinary actions on a worker to determine if he has sought workers' compensation insurance out of spite. Workers inclined toward insurance fraud may be pushed over the limit with probations and fines due to poor performance.

4. Look at the insurance claims history of an employee to determine the possibility of workers' comp insurance fraud. A flurry of insurance claims and requests for compensation without appropriate cause should increase your suspicion of a worker.

5. Witness a worker's physical condition outside of work to determine the likelihood that she has committed fraud. You may notice that a limp or other injury that created disability may disappear as an employee walks around town.

6. Connect the anecdotes and stories used by a claimant to determine the consistency of a worker's claims report. You should be able to read from start to finish without finding holes and inconsistencies in the events leading to disability.

7. Analyze the complicity of a business in a workers' comp insurance fraud scheme to complete your report. Companies may receive benefits to help replace the lost hours of a worker on compensation insurance, which provides a motivation for fraud.

Tips & Warnings

• Proceed through the union grievance process to report workers' comp insurance fraud. Union members found to have participated in insurance fraud may be banned from union activities in addition to suffering legal repercussions.

• Meet with an attorney familiar with state workers' comp laws before you complete a report. This meeting will help you become comfortable with state regulations and the language of insurance fraud so you can fill out a better report.