Fraud Detection & Prevention
How to Avoid Fraud
While very few claims are fraudulent, there are several important steps you should always follow to minimize fraudulent claims. This includes:
- Verification of references and work history upon hire.
- Immediate reporting of all claims.
- Reporting of suspicious activity or claims concerns to Accident Fund’s Fraud Hotline: 800-944-3728.
- Prominent display of the Accident Fund fraud poster in your workplace. Large quantities can be ordered from the policyholder site.
Examples of Workers’ Comp Fraud
- Falsely reporting payroll figures to reduce premium.
- A claim made for an injury sustained someplace other than at work.
- An employee collecting wage payments while working at another job.
- Physicians billing for services not rendered.
Fraud Warning Signs
- Claims reported first thing in the morning, especially on Mondays or just after lunch.
- Claims in which the details surrounding the incident change over time.
- A medical bill that reflects services not rendered.
- An injury sustained in a highly populated work area, but without any witnesses.
How to Report Fraud
If you or an employee suspect workers’ compensation fraud, call our anonymous hotline at 800-944-3728. All calls are strictly confidential. Or you may submit an online referral in the form below. Please provide as much detail as possible.