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Indications that a workers’ compensation claim is fraudulent

Many workers who file workers’ compensation claims have a situation that this type of insurance should cover. It isn’t very often that a worker will file a fraudulent claim, but employers should pay close attention to signs that there’s something amiss. 

While every situation is different, some signs are fairly common indicators that a workers’ compensation claim is fraudulent. You’ll want to take time to gather evidence showing that this is the case.

Questions to consider when determining if a claim is fraudulent

There are a few questions you’ll want to seek answers to when determining if you have a false claim on your hands. Consider these:

  • When did the injury occur?: If the injury occurred on an employee’s first day back at work after time off, then there’s a chance that it resulted from something that happened during their days off.
  • Does the worker have a motive to lie?: A worker who’s on the brink of termination might use a workers’ compensation claim to remain employed longer. 
  • Were there witnesses?: A lack of witnesses could mean that the accident that the worker claims happened on the job never actually occurred. 
  • Is the story consistent?: It’s hard for people to keep up with lies, so their stories might be inconsistent if they discuss them more than once. 

Any company that thinks that a claim for workers’ compensation coverage is fraudulent should take steps to determine whether that’s the case or not. Bogus claims can result in a considerable financial burden. It’s imperative that only valid claims receive benefits, so it can be helpful to learn how to best sniff out the fraudulent ones. 

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