Workers’ compensation insurance is meant to protect employees and businesses by covering medical expenses and lost wages for workers injured on the job. However, fraudulent claims can be a serious problem for New York contractors. One particularly frustrating scenario is when a worker files a claim months later—sometimes directly with the New York Workers’ Compensation Board—without notifying the employer at the time of the alleged incident. This can leave contractors blindsided, facing increased premiums and potential legal battles.

If you’re a contractor dealing with a fraudulent workers’ compensation claim, it’s essential to know your rights and how to defend yourself. Below, we outline steps you can take to fight back against fraudulent claims and protect your business.

How a Fraudulent Workers’ Comp Claim Can Happen

New York law allows workers to file a workers’ compensation claim within two years of an injury. However, some dishonest employees may exploit this system by filing fraudulent claims, often months after leaving a job. Contractors frequently encounter cases where a former worker claims they were injured on a site they never reported at the time. This can lead to a lengthy dispute, higher insurance costs, and unnecessary legal expenses.

The process usually unfolds like this:

1. You Receive a Notice from the Workers’ Compensation Board – Instead of being informed by the worker at the time of injury, you first learn of the claim when you receive an official notice.
2. The Employee Alleges an Injury from Months Ago – The worker claims they were injured while working for you but did not report it at the time.
3. You’re Asked to Respond – The Board and your insurance carrier will expect you to provide evidence or statements regarding the alleged injury.
4. Your Insurance Premiums Could Increase – If the claim is accepted, it could impact your experience modification rate (EMR), leading to higher insurance costs.

Steps to Defend Against a Fraudulent Workers’ Comp Claim

1. Gather Employment and Payroll Records

Your first line of defense is proving whether the claimant was even working for you at the time they claim they were injured. If you have accurate payroll records, timecards, or subcontractor agreements, you can use these to dispute false claims.

2. Check Incident Reports

If an injury truly occurred, it should have been reported at the time. If there was no report filed and no supervisors or coworkers recall an incident, this can support your case. Keep detailed records of all reported injuries to ensure fraudulent claims stand out.

3. Collect Witness Statements

Did anyone see the alleged injury occur? If the employee never mentioned an injury or worked without issue, getting statements from supervisors or coworkers can help disprove their claim.

4. Review Medical Records

If the claimant sought medical attention, their records should reflect the injury’s date and circumstances. Sometimes, fraudulent claims involve injuries sustained outside of work, and medical records may indicate inconsistencies.

5. Conduct a Background Investigation

If you suspect fraud, look into the claimant’s history. Have they filed multiple workers’ comp claims in the past? Are they currently employed elsewhere doing similar work? In some cases, hiring a private investigator can help gather evidence that disputes the claim.

6. Notify Your Insurance Carrier Immediately

Your insurance carrier has investigators and attorneys who specialize in workers’ comp fraud. The sooner they are involved, the better your chances of contesting the claim. Provide them with all relevant documentation, including employment records, witness statements, and any available surveillance footage.

7. Request an Independent Medical Examination (IME)

If the claim moves forward, you have the right to request an independent medical examination. This can help determine whether the injury is legitimate and work-related. If the worker refuses the IME, it could weaken their case.

8. Challenge the Claim with the Workers’ Compensation Board

If you have evidence proving the claim is fraudulent, you can formally challenge it. This process may involve hearings and legal representation. Be prepared to present your case with strong documentation.

9. Consider Legal Action for Fraud

If you can prove fraud, you may have grounds to pursue legal action against the claimant. New York law imposes penalties on individuals who commit workers’ compensation fraud, including fines and criminal charges.

How to Protect Your Business from Future Fraudulent Claims

Fraudulent claims can cost contractors thousands of dollars in increased premiums, legal fees, and lost productivity. Preventative measures can help protect your business.

• Require Immediate Injury Reporting – Have a strict policy requiring workers to report injuries immediately and in writing.
• Use Surveillance Cameras – Video footage from job sites can help dispute false injury claims.
• Maintain Detailed Employee Records – Keep accurate records of work schedules, job duties, and safety training.
• Conduct Post-Employment Reviews – If a worker leaves your company, document any injury claims they made before they left.
• Partner with a Workers’ Compensation Specialist – A workers’ comp expert can help monitor claims, prevent fraud, and keep your premiums as low as possible.

BGES Group – Your Workers’ Compensation Specialist in the Tri-State Area

At BGES Group, we specialize in workers’ compensation for contractors throughout New York, New Jersey, and Connecticut. We help businesses navigate complex claims, fight fraudulent filings, and keep their insurance costs under control.

With decades of experience, we know how to protect contractors from fraudulent workers’ comp claims that can drive up premiums and put businesses at risk. We offer:

✔ Claims Investigation Assistance – We work with top investigators to uncover fraudulent claims.
✔ Workers’ Comp Policy Optimization – We ensure you have the right coverage at the best rates.
✔ Fraud Prevention Strategies – We help you implement safeguards to prevent future fraudulent claims.
✔ Expert Representation – If a claim goes to court, we connect you with top legal professionals.

If you’re facing a fraudulent workers’ compensation claim or want to ensure your business is protected, contact us today.

BGES Group
📞 (914) 806-5853 – Gary Wallach
📧 bgesgroup@gmail.com
🌐 www.bgesgroup.com

Don’t let fraudulent claims put your business at risk. Let BGES Group help you fight back and keep your workers’ compensation costs under control.

In the construction industry, ensuring safety and managing risks are paramount. For contractors dealing with scaffolding, insurance is not just an option—it is a necessity. This blog explores the crucial role that scaffolding insurance plays in protecting contractors from potential liabilities and unforeseen events on site.

Understanding the Risks of Scaffolding Work

Scaffolding work inherently involves significant risks, including falls, equipment failure, and weather-related incidents. Each of these factors can lead to injuries or property damage, highlighting the need for comprehensive insurance coverage. Falls from scaffolding are one of the most common types of construction site injuries, sometimes resulting in severe consequences or even fatalities. Even with proper training and safety measures, accidents happen, making insurance an indispensable component of risk management.

Moreover, machinery malfunctions or structural weaknesses can also lead to collapse or damage, not only to the scaffolding itself but to surrounding structures and personnel. Natural elements like wind, rain, and snow exacerbate these risks by destabilizing scaffolding materials and creating hazardous work conditions. By understanding these threats, contractors can emphasize the importance of having a robust insurance plan tailored to their specific projects.

The Role of Scaffolding Insurance in Risk Management

Scaffolding insurance is crucial in managing the myriad risks associated with construction work. It offers financial protection against accidents and ensures compliance with legal safety standards. Policies typically cover third-party injuries, property damage, and employee-related incidents, thus safeguarding contractors from potentially crippling legal and financial repercussions. In cases where accidents result in lawsuits, having insurance can be the difference between sustaining an operation and facing closure.

A key benefit of having scaffolding insurance is the confidence it instills in business partners and clients. Knowing that a contractor is covered by a comprehensive policy can enhance their reputation and reliability, leading to more opportunities and stronger business relationships. This assurance can significantly impact a contractor’s ability to secure projects, especially in a competitive market where safety and professionalism are paramount.

Key Components of a Comprehensive Scaffolding Insurance Policy

A comprehensive scaffolding insurance policy typically covers several critical components essential for effective risk management. General liability insurance is a fundamental aspect, offering protection against claims involving third-party injuries or property damage. This coverage is essential for any contractor since incidents such as falling debris or equipment mishandling can lead to costly legal actions.

Worker’s compensation insurance is another vital component, providing financial support for employees who suffer injuries on the job. Covering medical expenses and lost wages, this insurance is crucial in maintaining a healthy relationship with your workforce and ensuring their needs are addressed promptly. Additionally, property insurance protects against loss or damage to scaffolding equipment caused by unforeseen events such as theft or vandalism, ensuring business continuity and minimized financial strain.

Realizing the importance of these components allows contractors to engage proactively with their insurance provider, ensuring that all potential risks are covered. Such thorough coverage not only safeguards the contractor’s assets but also promotes a culture of safety and responsibility within the organization.

Choosing the Right Insurance Provider

Selecting the right insurance provider is pivotal for contractors seeking scaffolding insurance. Contractors should consider providers with a strong track record in the construction insurance industry and ones that offer a breadth of customizable policies. It’s important to evaluate a provider’s experience, responsiveness to claims, and ability to craft policies that address specific risk factors relevant to scaffolding work. The role of an insurance provider extends beyond offering coverage; they need to be a trusted partner in risk management.

When evaluating providers, contractors should explore their understanding of construction-specific risks and their ability to offer tailored advice. A reliable provider not only facilitates understanding the complex insurance landscape but also assists during the claims process, ensuring prompt settlements. Moreover, choosing a provider who can offer insight into additional safety measures can further bolster a contractor’s risk management strategy. The BGES Group is an example of a provider that offers such comprehensive coverage for contractors.

Real-Life Scenarios Where Scaffolding Insurance Proved Vital

Consider a situation where a major storm hits a construction site overnight, causing scaffolding to collapse. In such a case, scaffolding insurance can cover the costs involved in repairing or replacing the damaged structures, mitigating financial losses. Additionally, if any workers or third parties suffer injuries due to the collapse, scaffolding insurance is instrumental in managing medical costs and potential legal disputes. These real-world scenarios illustrate the invaluable role of scaffolding insurance not just as a safeguard but as a financially strategic asset in a contractor’s operational toolkit.

Another significant scenario involves machinery malfunction leading to a structural failure, causing debris to fall onto neighboring properties. Scaffolding insurance steps in to cover damage repairs and settle any third-party claims, allowing the contractor to address issues without jeopardizing their financial stability. Such instances reinforce the importance of having a comprehensive policy that offers broad-spectrum protection, enabling contractors to focus on their work while minimizing operational risks. Learning from these scenarios emphasizes the necessity of investing in scaffolding insurance to ensure both safety and business longevity.

Securing Peace of Mind with Scaffolding Insurance

In conclusion, scaffolding insurance offers essential protection for contractors, securing their operations and providing peace of mind on potentially hazardous job sites. By understanding its importance and choosing the right policy, contractors can focus on their projects confident in the knowledge that they are well-protected against unforeseen incidents. For all your construction insurance needs, visit the BGES Group Business Homepage.

BGES Group is one of New York, New Jersey, and Connecticut’s Construction Insurance Specialists representing 50+ companies, including all the BEST general & umbrella liability programs. We offer all the coverage needed, including property, builders’ risk, inland marine, general liability, umbrella liability, auto, bid & performance bonds, workers’ compensation, N.Y.S. disability, and group health.  Our commitment to you goes beyond the policies we provide. We are always just a call, text, or email away, ready to assist you, even on weekends. We understand the importance of your business and are here to help you navigate any insurance challenges. 

BGES Group are Workers’ Compensation Insurance Specialists for Tri-State Business Owners: Unhappy with your rates, company, being canceled, losses causing difficulty getting coverage, in the middle of an audit dispute, misclassified payrolls, or whatever your issue. We can help!  We have special programs for Auto Services, Contractors (especially in New York), Limousine Services, Logistics Companies, Manufacturers, Recyclers, and Truckers; we can help ANY tri-state business owner. We are considered “Preferred Agents” for this one program that, if we can get you into, their pricing is excellent, offers long-term coverage stability, and can cover multi-state operations. The program takes the hassle out of doing annual audits, too.  

If you want to speak with us, call Gary Wallach at 914-806-5853, click here to email, or visit our website. 

Company: BGES Group, 216A Larchmont Acres West, Larchmont, NY 10538

email: bgesgroup@gmail.com

website: http://www.bgesgroup.com

© – Copyright – 2025 – BGES Group
 

When it comes to workers’ compensation insurance, how you classify your payroll can make a massive difference in your premiums. Many New York contractors unknowingly overpay for coverage simply because they don’t separate their payrolls by class codes. For businesses performing multiple trades, such as asbestos abatement contractors who also handle interior demolition, insulation, and other services, correctly splitting payrolls can mean the difference between a reasonable premium and an astronomical one.

This article will explore why payroll separation is crucial, how to properly set up your bookkeeping to ensure compliance, and how BGES Group can help contractors get the best workers’ compensation solutions.

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Why Separating Payrolls by Class Codes Matters

Workers’ compensation insurance premiums are based on payroll and job classification codes assigned by the National Council on Compensation Insurance (NCCI) or the New York Compensation Insurance Rating Board (NYCIRB). Each trade or role in a company is assigned a specific class code, with some codes carrying significantly higher rates than others.

Let’s take the example of an asbestos abatement contractor who performs multiple trades:

• Asbestos Removal (5473) – A high-risk class code with one of the most expensive workers’ compensation rates.
• Interior Demolition (5403) – Another high-risk category, though often lower than asbestos removal.
• Insulation Work (5479) – While still construction-related, insulation work may have different rates than asbestos removal.
• Supervisory (5606) – Contractor executive supervisors who do not perform manual labor can be classified under this lower-rated code.
• Clerical (8810) – Office employees who never set foot on a job site are classified under this ultra-low-cost class code.

If a contractor fails to separate payrolls properly, insurance carriers often default all wages to the highest-rated classification—meaning your entire payroll could be charged under the costly asbestos removal rate. This mistake could cost tens of thousands of dollars in excess premiums annually.

By splitting payrolls correctly, businesses can ensure each employee’s wages are assigned to the appropriate (and lowest applicable) classification, significantly reducing insurance costs.

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How to Properly Separate Payrolls for Workers’ Compensation

Insurance auditors will scrutinize payroll records to ensure proper classification. If payroll is not meticulously recorded, they will automatically classify all wages under the most expensive category. To avoid this, contractors should implement the following best practices:

1. Maintain Detailed Payroll Records

• Record each employee’s hours and job duties separately.
• Use time-tracking software that allows employees to log specific tasks or trades they performed.
• Have supervisors verify and approve job classifications daily or weekly.

2. Use Job Costing Codes in Accounting Software

• Set up job costing codes within accounting and payroll systems to reflect different class codes (e.g., QuickBooks, Sage, or specialized construction accounting software).
• Each payroll entry should specify the exact work performed under the correct classification.

3. Clearly Define Employee Roles

• Employees should be trained on how job classification works.
• Supervisors should ensure workers are not performing multiple trades under a single shift unless necessary.
• Ensure that executive supervisors (5606) and clerical employees (8810) do not engage in manual labor. Even one instance of a clerical worker visiting a job site and performing labor could reclassify their entire payroll at a higher rate.

4. Require Accurate Time Cards

• Utilize electronic time cards or job logs that specify the nature of work completed.
• If using manual logs, ensure they are legible, signed, and retained for audits.

5. Work With a Workers’ Compensation Specialist

• Insurance carriers conduct audits annually, and misclassified payrolls can lead to massive additional premiums and penalties.
• A specialist like BGES Group can ensure your classifications are correct before an audit takes place, helping to prevent unnecessary costs.

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How BGES Group Helps New York Contractors Save on Workers’ Compensation

BGES Group is one of New York’s top workers’ compensation insurance specialists. With over 40 years of experience, they help contractors navigate the complex world of workers’ compensation, ensuring proper payroll classification, lower premiums, and audit compliance.

Why Contractors Trust BGES Group:

• Expert Classification Assistance – They analyze your business operations and payroll records to ensure correct class codes, preventing overcharges.
• Exclusive Workers’ Comp Programs – BGES Group offers special programs for high-risk contractors, including asbestos abatement, roofing, demolition, and insulation.
• Audit Support & Dispute Resolution – If you’re hit with an unexpected premium increase after an audit, BGES Group fights on your behalf to get it corrected.
• Payroll Services with Workers’ Comp Integration – They offer payroll solutions that automatically classify employees correctly, ensuring compliance and minimizing risk.

By working with BGES Group, contractors can save thousands of dollars annually by avoiding misclassifications and securing the most competitive workers’ comp policies available.

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Contact BGES Group Today

Don’t let improper payroll classification drain your profits. If you’re a New York contractor looking to lower your workers’ compensation costs, BGES Group can help.

📞 Call Gary Wallach at 914-806-5853
📧 Email: bgesgroup@gmail.com
🌐 Visit: bgesgroup.com

With BGES Group on your side, you’ll get expert guidance, lower premiums, and the best workers’ compensation solutions tailored to your business. Reach out today to start saving!