Potential Signs of Fraudulent Workers' Compensation Claims
1.
2. For the last 15 years, Kristin Swanson-Mace has served
as president, chief executive officer, and sole
practitioner at her law firm in Orlando, Florida. In her
primary role with the firm, Kristin Swanson-Mace
represents employers and carriers in defense of
workers’ compensation claims.
Roughly one-quarter of insurance fraud claims in the
United States can be attributed to workers’
compensation. With this in mind, employers and their
legal representatives must remain wary of potentially
fraudulent claims. Any claim made that cannot be
supported by witnesses testimony should always be
carefully reviewed, particularly if the claimant’s job
does not involve solitary work.
3. Employees may sometimes injure themselves
off of work grounds or at home over the
weekend and attempt to make a personal
injury claim through their employer. The timing
of a reported injury, such as early on a Monday
morning, may be indicative of such a situation.
Finally, repeat claims should be thoroughly
investigated. About 37 percent of first-time
claimants will make a second personal injury
report. Whether this behavior suggests
insurance fraud or unsafe work conditions, an
employer should take repeat claims very
seriously.