Fraud Prevention

Some find it tempting to cheat the workers’ compensation system. The crime is an economic and social drain. Nationally, it costs billions each year and everyone pays—from higher premiums to undermining the legitimately injured worker who deserves every payment.

MEMIC is dedicated to fighting the hidden threat of fraud. Our special investigation unit—manned with seasoned, former law enforcement—works year round investigating 2 to 3 times as many doubtful claims as the industry average.

10 Ways for Employers to Fight Workers' Comp Fraud

1. Promote a Fraud-Free Workplace

Talk to your employees about workers’ compensation. Eliminate misconceptions by explaining what it is, how it works and your zero tolerance stance on fraud. Use posters and employee newsletters to spotlight workers’ comp fraud as a serious crime. Also, let employees know how they can report fraud anonymously.

2. Use Sound Hiring Practices

Stop workers’ comp fraud from the start. Run thorough background checks on would-be employees before hiring. You might be surprised to find past phony workers’ comp claims or other types of fraud convictions. If you have questions about anything you find, ask them to explain.

3. Install Video Equipment

Monitoring is a proven spoiler of fraud and other workplace crimes.

4. Consider Drug Testing

Drug users do not make the best employees. They’re unsafe workers and are more likely to file false claims. Spot potential cheats and keep safety a priority by testing for alcohol and drug use. Have a plan if someone is injured

5. Designate Someone to Be in Charge When an Injury Happens

• Promptly recommend your predetermined medical provider
• Get a description of the accident and injury
• Report the injury right away to your administrator
• Preserve workplace evidence
• Get names of witnesses

6. Start a Safety Program

Make workplace safety a priority. Hold regular safety meetings. Use posters, flyers and newsletters to stress safety procedures. Reward workers for meeting safety milestones. A safe workplace makes fake injuries harder to legitimize.

7. Know the Red Flags of Fraud

• Sketchy work history or “job jumper”
• Child support lien
• Extensive criminal record
• Exaggerated details about incident or symptoms
• Co-worker skepticism

8. Know the Role of Our Special Investigation Unit (SIU)

SIU is the CSI of the insurance world. Our specialists are trained to investigate signs of doubtful claims, and after thoroughly doing so, they will share their relevant findings with the law. Have suspicions of fraud or abuse? Contact us at 1-800-ABUSEWC or fill out our online report fraud form.

9. Pay Attention to Worker Scuttlebutt

After a workplace injury, and throughout the claims process, rumors of foul play may filter through the workplace. Keeping an ear to the grapevine may help in weighing a claim’s validity.

10. Pave the Way for Return to Work

Let employees know every attempt will be made to get injured employees well again and back to work. Prepare a written return-to-work plan that includes temporary or alternative duties.