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You are here: Home / Claim Management / Fight Workers Comp Fraud & Abuse / Workers Comp Fraud Does Have Solutions

Workers Comp Fraud Does Have Solutions

April 29, 2010 By //  by Robert Elliott, J.D. Leave a Comment

A Quakertown, Pa. waitress who informed her employer she hurt her back on the job and could no longer work was apparently not in too much pain that she couldn't get in a little daily exercise For more information: http:www.ReduceYour WorkersComp.com


The woman was arrested on workers’ compensation fraud charges after authorities discovered she was working as a stripper at a club while collecting benefits. The woman now faces theft and insurance fraud charges in connection with the alleged false claims, according to the state Attorney General's Office, being charged with two counts of workers’ comp insurance fraud and one count of theft by deception. Each charge carries a maximum penalty of seven years in prison and a $15,000 fine.

According to authorities, the woman informed her employer on Nov. 9, 2007, that she slipped and fell during her shift, hurting her back, and quit prior to her shift ending. Her former employer, Red Robin, submitted an accident report to its insurance carrier three days later.

It was reported the woman allegedly told her doctor she was unable to work and standing and changing positions was difficult. Eight days later, she was observed working as an exotic dancer, the Attorney General's Office said. (workersxzcompxzkit)

The employer paid $22,727 in disability benefits and $4,118 in medical expenses relating to the woman’s claim.  

 

A Quakertown, Pa. waitress who informed her employer she hurt her back on the job and could no longer work was apparently not in too much pain that she couldn't get in a little daily exercise.

The woman was arrested on workers’ compensation fraud charges after authorities discovered she was working as a stripper at a club while collecting benefits. The woman now faces theft and insurance fraud charges in connection with the alleged false claims, according to the state Attorney General's Office, being charged with two counts of workers’ comp insurance fraud and one count of theft by deception. Each charge carries a maximum penalty of seven years in prison and a $15,000 fine.

According to authorities, the woman informed her employer on Nov. 9, 2007, that she slipped and fell during her shift, hurting her back, and quit prior to her shift ending. Her former employer, Red Robin, submitted an accident report to its insurance carrier three days later.

It was reported the woman allegedly told her doctor she was unable to work and standing and changing positions was difficult. Eight days later, she was observed working as an exotic dancer, the Attorney General's Office said. (workersxzcompxzkit)

The employer paid $22,727 in disability benefits and $4,118 in medical expenses relating to the woman’s claim.

 
The point is not  that a woman was caught cheating the system, but what can an employer do about fraud and abuse for workers compensation. Lots of things. From the IT perspective, consider predictive analytics. From the TPA side, consider fraud posters. From the investigation side, consider surveillance and anonymous tips lines. From the employers perspective, consider asking your insurance company for any tools they have available because we all pay for this type of abuse. Yes, a large insurance company administers the benefits but the company (or state or federal government) ultimately has to cover the overhead for a program which is meant to cover workers with legitimate injuries.

 
Author Robert Elliott,
executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, healthcare, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at:  Robert_Elliott@ReduceYourWorkersComp.com or 860-553-6604.

 
Podcast/Webcast: Occupational Health Strategies
Click Here:

http://www.workerscompkit.com/gallagher/podcast/Occupational_Health_Strategies/index.php

WC Calculator: http://www.reduceyourworkerscomp.com/calculator.php

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers' comp issues.

© 2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ ReduceYourWorkersComp.com.

Filed Under: Fight Workers Comp Fraud & Abuse Tagged With: Workers Comp Fraud

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