Workers’ compensation fraud is a prevalent issue that can significantly impact New York contractors, leading to higher premiums, financial losses, and even policy cancellations. Understanding the most common fraud claims can help contractors protect their businesses. Here are the five most common workers’ compensation fraud claims that New York contractor employees attempt:
1. **Exaggerated Injuries**
A frequent type of workers’ compensation fraud involves employees overstating the severity of their injuries. While the injury may be legitimate, the employee might claim it is more debilitating than it is, resulting in prolonged time off and increased compensation. Contractors can combat this by ensuring thorough medical evaluations and regular check-ins with injured employees.
2. **Non-Work-Related Injuries**
Some employees may attempt to pass off injuries sustained outside work as work-related incidents. This type of fraud can be challenging to prove, especially if there are no witnesses. Contractors should enforce strict reporting procedures and encourage immediate reporting of all injuries to verify the authenticity of claims.
3. **Malingering**
Malingering involves employees claiming benefits after they have recovered enough to return to work. They may extend their recovery period to receive extended benefits. Contractors can counter this by requiring regular medical updates and fitness-for-duty evaluations to ensure employees return to work as soon as possible.
4. **False Claims of Injury**
In some instances, employees may fabricate an injury entirely. This type of fraud is less common but can be extremely costly. Contractors should maintain a thorough investigation process for all reported injuries, including reviewing surveillance footage, if available, and interviewing potential witnesses to determine the claim’s legitimacy.
5. **Working While Receiving Benefits**
Also known as “double-dipping,” this type of fraud occurs when employees collect workers’ compensation benefits while working another job. This illegal practice unfairly burdens the employer. Contractors can mitigate this risk by conducting periodic surveillance and monitoring social media for signs that an employee is working elsewhere while claiming benefits.
Conclusion
Highlighting workers’ comp fraud is crucial for New York contractors. Fraudulent workers’ compensation claims can have severe financial repercussions, leading to increased workers’ compensation insurance costs and even policy cancellations. By being aware of these common types of fraud and implementing robust prevention and detection measures, contractors can protect their businesses from unnecessary losses.
If you are a New York contractor with several claims causing problems with the cost of your workers’ comp or if your insurance company is canceling your policy, contact Gary Wallach at BGES Group. Gary is a New York workers’ compensation specialist who can help you find a new policy. His phone number is 914-806-5853.
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.
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