Fraud Prevention Program Scores a Hit!
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program targeting workers’ compensation insurance fraud resulted in 154 arrests in 2009 and $16.6 million in recoveries and estimated savings as reported by the New York State Insurance Fund (NYIF).Since 1995, NYSIF cases accounted for 1,382 insurance fraud arrests, along with recoveries and estimated savings of $183.1 million. During that time, NYSIF established a national reputation for fighting workers’ comp fraud by working cooperatively with the New York State Insurance Department Frauds Bureau, the Workers’ Compensation Board Inspector General’s Office, local, state and federal law enforcement authorities, and district attorneys in many jurisdictions in and out of state.
“NYSIF has long been a leader in the fight against workers’ compensation fraud and our results this year again show we continue to lead the fight,” NYSIF Chief Deputy Director Francine James said.
“That’s a commitment we make as the state’s largest workers’ compensation insurance company to the people and all businesses of the state of New York . Workers’ compensation fraud is not a victimless crime, it is a felony and we vow to pursue it as such.”
Among anti-fraud special investigation units, NYSIF DCI ranks near the top nationally in annual arrests, and in cumulative fraud savings. In addition, NYSIF auditors have established a standard among insurance carriers for conducting premium audits that discourage improper payroll reporting and worker misclassification.
Recent significant cases resulting in millions of dollars in savings to NYISF have included claimants who receive benefits while operating businesses or remain employed in other capacities, the most prevalent type of workers’ comp fraud. (workersxzcompxzkit)
Other cases involve premium fraud, the most costly type, in construction, asbestos abatement and other contracting, including investigations in conjunction with the U.S. Department of Labor, the U.S. Postal Inspector, and local labor racketeering bureaus. Still other cases involve fraudulent provider billing.
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, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: [email protected] or 860-553-6604.
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