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Workplace Safety

How Well Do You Know Your Coverage: Current Fraud Cases and You

By March 7, 2016No Comments

wc-0316-2Owning a business or even managing one comes with a huge set of responsibilities, but there are probably only a few that really get attention on a daily basis. Sometimes meetings are called to bring attention to this matter or the next, but it likely gets buried along with the information you don’t regularly use. How can you expect to know your workers comp coverage policies if it’s not something on the pressing list of concerns for the day? Here are a few tips to understanding more so you can have fewer exposures to fraud.

Workers comp is fortunately not extremely common, and the number of cases filed is down. Most people don’t know anyone who has ever filed, and you may have very limited exposure to it aside from forms full of words you’re likely never going to read. However, the most important factor here is that workers comp involves money which is a powerful incentive for people. Recently in California, there were doctors and providers who were uncovered in a large-scale fraud operation that involved receiving kickbacks for the treatments and prescriptions given to mainly Latino workers. This was all done via a highly advanced organization with employees all the way down the chain of command placing flyers in trucks to call a number if they’d been injured. There is also interpretation fraud discovered at the end of December with people billing for services that weren’t necessary for injured parties. And of course there’s fraud of employees faking an illness.

Obviously you can’t stop these types of things from happening, but if you think you’re not affected by all of this, then you’re mistaken. Fraud pushes everyone’s rates up and knowledge really can be the key to stopping it from happening at all. Understanding your policies can prevent fraud before it happens. When you keep up with new laws, reforms and the current political landscape, you increase the chance that you’re doing what you can do in terms of taking responsibilities for your employee’s welfare. It can also make you more likely to detect patterns that may signify something fishy going on.

In the case of the fraud operation, it was very well planned and everyone knew what was expected of them. However, the way they were caught is because they wanted to expand. Criminals are not above making a mistake, and your mindfulness can be just the key to noticing an anomaly in an employee. Also, you have rights guaranteed by your particular coverage which can also be your saving grace. You do not have to be a victim of fraud when you know your coverage and who your employees are.