How to Protect Your Business From a False Workers’ Compensation Claim
Even in a large company, a false compensation claim can be immensely damaging. It is important to recognise the common aspects of a false claim and how you can protect your organisation.
The current state of affairs serves as an accurate example of the old adage that “desperate times call for desperate measures.” Crime rates are high, fraud cases are aplenty, and it’s easy to see why we need to keep our guard up. A false workers’ compensation is just one of the many things that business owners need to keep an eye out for, both during the COVID-19 pandemic and afterwards.
A workers’ compensation claim is a measure that protects employees from the financial burdens that come with a severe workplace accident. This is different from a personal injury claim in that the goal of a personal injury claim is to determine whether liability is ascribed to the defendant or not.
Contrary to this, a workers’ compensation claim delves in the eligibility of the claimant, and attempts to ascertain if the circumstances of the accident entitle the claimant to compensation. It does not affix a negative connotation on the employer, but rather it seeks to determine a claimant’s eligibility.
An employee may file a workers’ compensation claim against his employer as a way to get money to pay for medical treatment, even when the employer had nothing to do with the accident. Here are some of the signs that employers need to look out for so they’re able to detect this type of fraud:
The Report is Filed on a Monday Morning
This should raise suspicion due to the possibility that the accident happened over the weekend, which means that the claimant was not at work, nor was the claimant performing the duties associated with their employment. It’s not uncommon for employees who do not have health insurance to file a false claim so that the employer ends up paying for their medical treatment.
Claimant Refuses to Undergo Diagnostic Procedure
A diagnostic procedure is the best way to determine if and how an employee sustained an injury, as well what treatment is best suited for them. There is no reason why an injured person would refuse a diagnostic procedure, especially when they are told that the process is free.
Vague Accident Details
While vague details can be a result of an employee’s inability to express themselves properly, they can also be cause for suspicion, especially when the claimant’s statements are self-contradictory. This does not automatically count as a false claim, but rather, it should be enough to compel you to investigate further.
No Witness to the Accident
Another sign that should put you on your guard is if the claimant asserts that there were no witnesses to the accident. It’s difficult to justify such an assertion, especially if you have a small building or hundreds of employees.
Again, this doesn’t necessarily automatically disqualify the claimant, but you should take this as a sign that you need to be wary of the claim. And if it does go to court, you might even want to consider getting an expert witness testimony to help strengthen your case.
Business owners aren’t helpless against fraudulent claims. You can hire lawyers to help protect yourself against fraudulent workers’ compensation claims. During times like this, it’s important to stay vigilant.