Five steps to preventing fraud
Depending on your workforce, you may benefit by taking steps to prevent or minimize workers' compensation fraud among your employees. They cost nothing except effort.
Fraud can impair productivity, degrade employee morale and eat away at your bottom line. You're ahead of the curve by planning preventive steps now rather than paying the price later.
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Your organization should already have a policy of encouraging employees to report injuries and to do so promptly. You can incorporate your organization's intolerance for fraudulent reporting into that statement. SFM has developed a written sample to help get you started on laying out your organization's employee handbook policy on fraud. You can download or order the "Employee handbook policy" CompTalk here.
Depending on your workplace culture, you may want to let your employees know in other ways that both your organization and your insurer have no tolerance for workers' compensation fraud. For instance, you may want to post a notice telling employees what to do and whom to call when they have information about a fraudulent claim. This kind of posted notice might be particularly effective if you recently had an instance where an employee tried to defraud the system and word was getting around to other employees. You need to get out a "Don't even think about it" message to others. Remember, most employees get upset by fraud and will report it if given the opportunity.
A posted notice can also help in special situations where the likelihood of fraud increases, such as prior to a layoff or strike, or after seasonal employment ends. |
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Show fairness, respect and concern for your employees. This includes respect and support for the legitimately injured. Good relations help deter bad behavior.
Pay attention especially to employees who are unhappy, such as those facing a layoff.
Keep employees' addresses current. Besides getting important claims-related information to the right address, SFM may dispatch an investigator to pay a visit to the employee's home.
Conduct exit interviews. Document that the employee is leaving without injury. |
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Fraud is known to have a greater likelihood of occurring under certain circumstances. |
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Document rumors and observations. These will most likely be things you hear and see at your workplace, but they could come from outside, too. |
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Don't try to investigate a suspicious claim yourself or try to build a case by talking with others. Your role is to let SFM know about your suspicions--what you know, what you've heard, what you've seen. Tactfully building a fraud case without tipping off the suspected wrongdoer is the job of SFM's experienced special investigators and attorneys. |
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