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HOW IT WORKS ● WHAT YOU'LL GET ● WHY CHOOSE WORKERS' COMP KIT
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Workers Comp Fraud Control
Do you use all techniques available to eliminate workers' comp claims?
A very small percentage of workers' comp claims are fraudulent, but quite a few claims are "exaggerated." In other words, the claim lasts longer than the medical disability. The employee has recovered but has not returned to work.
Some people take advantage of the system by staging accidents, faking injuries or pretending they are injured more seriously than they are. These claims can be very frustrating for an employer, but methods exist to prevent or reduce the incidents of fraudulent workers' comp claims.
I recently worked with a company that had $1,500,000 in incurred losses. When I looked at the data summary, only $100 had been spent for investigation services. Spending a mere $100 to control 1.5 million dollars of claims is not realistic. Therefore, we revamped the system and allocated more money to controlling claims. The following year, the company spent $41,000 - on investigation and medical review - and the claims costs dropped to $500,000. Thus, the company spent $41,000 to save $1-Million dollars! That's a 2,339% return on investment!
5 Ways to Eliminate Fraudulent Workers' Compensation Claims FOREVER!
- Fraud tip lines & anti-fraud posters
- Investigation
- Check endorsement statements
- Use doctors proactively
- Medical investigation
Is YOUR Company using 100% of these techniques to control fraud?
The Workers' Comp Kit® Fraud & Abuse Module teaches you how to:
- Spot the red flags of fraud
- Ask the adjusters for the appropriate type of investigation
- Recognize the four times when an investigation is crucial
- Guide the investigators on your team
- Read and review surveillance reports, videotapes and photographs
- Coordinate investigation results with medical advisors
- Initiate an anti-fraud program that includes a toll-free tip line
- Learn the legal obstacles to investigation
- Coordinate return to work with an MD or Nurse - when a facility nurse or medical director reviews every injury, it is a huge deterrent to malingering and fraud
- Investigate questionable claims from a medical perspective and determine non-occupational causation
- Understand how even though investigation expenses are charged back to your company, there may be a disincentive for the TPA to use investigative services on your claims
Fraud-Reduction Forms and Documents
The forms and documents you need are in the Fraud & Abuse Module of Workers' Comp Kit®:
- Letter Requesting Investigation
- Letter to TPA Enclosing Report
- Letter to Employee's Doctor
Learn about WORKERS' COMP KIT® IMPROVEMENT PLAN
Do not use this information without independent verification. Laws are different in each state. Check with corporate legal counsel before implementing any steps on this website.
For more information about how you can greatly reduce your Workers' Compensation costs, call us at 860-553-6604, or send us an e-mail, or simply submit this short form.
