Mistrust of employees is not a smart way to approach business but, unfortunately, fraud does happen. The key is to make it clear to employees your business won’t tolerate fraud and is able to spot abuse.
First of all, understand the difference between fraud, abuse and malingering.
Fraud: An intentional deceit perpetrated for profit.
Abuse: To use wrongly or improperly; misuse.
Malingering: To pretend illness especially in order to avoid work.
Five Tips on Spotting Fraud
1. List the key indicators of malingering, fraud, and abuse.
2. Know how to notify the adjusters of claims with “red flags.” (See blog on “25 Red Flags of Fraud”).
3. Know how to follow up on claims where you suspect fraud, abuse, and/or malingering.
4. Inform all employees the company is embarking on a fraud investigation program.
5. Incorporate a fraud prevention service such as a “tip line” and publicize the telephone number and use it to combat fraud and abuse. (workersxzcompxzkit).
Author: Robert Elliott, J.D.
Click on these links to try it for yourself.
WC Calculator: www.ReduceYourWorkersComp.com/calculator.php
TD Calculator: www.ReduceYourWorkersComp.com/transitional-duty-cost-calculator.php
WC 101: www.ReduceYourWorkersComp.com/workers_comp.php
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
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