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You are here: Home / Post Injury Systems / Communication with Employees / Fraud Abuse and Malingering Different Shades of Same Problem

Fraud Abuse and Malingering Different Shades of Same Problem

August 9, 2009 By //  by Robert Elliott, J.D. Leave a Comment

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: The intentional deceit perpetrated for profit.

Abuse: To use wrongly or improperly; misuse.

Malingering: To extend illness to avoid work.

Five Tips on Stopping Fraud

1. Be able to List the key indicators of malingering, fraud, and abuse.

2. Know how to notify the adjusters of claims with “red flags.” (See our 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). Almost all workers’ comp insurance carriers have fraud hot lines.

Author: Robert Elliott, J.D.

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

All state laws vary. Do not use this information without independent verification.
©2008 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com

Filed Under: Communication with Employees, Fight Workers Comp Fraud & Abuse Tagged With: Combating Fraud

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