Insurance claim fraud is at an all-time high. In many areas of the United States some parts have at least 20% or more of the worker’s compensation cases in a “fraud” potential status. Many States require that each insured’s company have afraud unit that they use that unit to mitigate claims that are unfair and fraudulent. Unfortunately, we find that the insurance carriers have generally understaffed and underfunded this section and found it more expeditious to settle a claim rather than to fight.While there needs to be an understanding between the employer and his worker’s compensation insurance company, at times it is wise to settle a claim in spite of the little or no liability. There are also times when it is more worthy to entice the insurance carrier “to fight it” in order for not only the insured but the rest of your workforce to understand that fraud is not acceptable in your company’s operations.
As you can see by the above, you have a lot to play with when you are dealing with your worker’s compensation insurance coverage. This means not only a lot of responsibility, but a lot of opportunities to be helpful to an employee who has a valid injury and to your company when the injury is exaggerated or fraudulently presented.