Why Workers Comp Fraud Doesn’t Pay

Ask any business owner and he or she will tell you that insurance is not just about commercial general, professional, and employee liability or property coverage. Generally, it is legally mandatory for a business to acquire workers compensation coverage so that employees will be able to claim benefits in the event they incur a work related injury.

So, it’s a fact – workers comp is an important factor in any company’s insurance portfolio.

The problem lies when a worker files a fraudulent claim. And, unfortunately, it happens fairly often. But contrary to what many believe, workers comp fraud does not just impact businesses and bosses, and the employees that go about life in a totally honest manner, it also affects the faker. File a fake workers comp claim and you risk losing your job, spending time behind bars, and paying expensive fines. Trust those in the industry: crime – as it relates to workers comp – surely does not pay!

Below you will find some examples of employee benefits services that thought they could earn some bucks while fooling the system. In the long run, the hoax turned on them.

Fake Workers Comp Claim – True Scenarios

1. Marc was employed as a gardener. One day, he slipped and fell on the job. Complaining about associated pain that rendered him unable to work any longer, Marc submitted a workers comp claim. The process went rather smooth and it did not take long for Marc to begin receiving his disability benefits. Unbeknownst to Marc, however, the insurance company was after his tracks. After viewing surveillance video showing Marc actively doing gardening work for two other properties, Marc was called to task. Not only would the disability checks be curtailed, but he was sentenced to four months of jail time and ordered to pay over $39,000 in fines.

2. Jack complained about injuries he incurred at work. He said the resulting back pains made it impossible to continue his employment. Jack told the attending doctor that he had not experienced any pains prior to his work injuries. It didn’t take long for the insurance to offer proof that Jack was lying about his inability to work. The surveillance camera caught him working as a landscaper in the family business following the claim he made, resulting in a 3-year prison term and a $14,500 fine.

3. Sarah filed a workers comp claim after she received injuries to her back and leg while walking up a slope at the business’s outdoor facilities. When filing, Sarah failed to reckon with the ability of the insurance company’s investigation department. The department’s thorough work uncovered the true nature of the injuries: the injuries had been incurred before the date given on the claim and so were the discussions fellow employees had with her about them. Sarah was given 120 days jail time, plus 5 years of probation, plus a fine of $28,000!