Fraud, Straight to Video By Robert Warne - February 27, 2003
In an effort to educate the public regarding workers’ compensation fraud, the California Department of Insurance (CDI) has produced a video on the subject.
With the help of the Amador County District Attorney’s office the video focuses specifically on employer and employee fraud and provides general examples of each.
It highlights some of the classic red flags that have been traditionally linked to fraudulent claims.
The video acquaints viewers with the disgruntled employee and soon to retire or be laid off claim scenarios. It also urges employers and co-workers to keep an eye out for claims filed by employees who have a history of claiming subjective injuries such as pain or headaches. Other fraudulent activities may also be signaled by employees reluctant to return to work after filing a claim and those who never seem to improve.
Employers are also instructed in respect to certain circumstances that lend themselves to a higher occurrence of fraud.
Weekend warrior claims that occur late Friday or early Monday are to be treated with a certain degree of suspicion. And claims for accidents with no witnesses or conflicting stories from witnesses should be given some extra attention. Also pointed out is that it isn’t uncommon for an employee to file a bogus claim just prior to disciplinary action or near the end of a probationary period.
The DOI and the DAs are anxious to turn up the heat on those who have committed workers’ compensation fraud or are who think they can commit fraud and get away with it. These entities along with insurers and all California citizens are tired of their budgets and pocket books shriveling because of the estimated $5 billion a year work comp fraud consumes.
Adjuster / Examiner Claims Examiner Santa Ana Unified School District Santa Ana, CA
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