Ask any business owner and he or she will tell you that insurance is not just about commercial general, professional and employee liability or property coverage. In general, it is required by law for a business to acquire workers’ compensation coverage so that employees will be able to claim benefits in the event that they sustain a work-related injury.
So it’s a fact – workers’ comp is an important factor in any company’s insurance portfolio.
The problem lies when a worker files a fraudulent claim. And unfortunately it happens quite often. But contrary to popular belief, worker fraud does not only affect companies and managers and the employees who go about their lives in a completely honest way, it also affects the counterfeiter. File a false workers comp claim and you risk losing your job, spending time behind bars, and paying expensive fines. Trust those in the industry: crime – as it relates to workers’ comp – sure doesn’t pay!
Below you will find some examples of employees who thought they could make some money while cheating the system. In the long run, the scam turned against them.
False Workers Comp Claims – True Scenarios
1. Marc was employed as a gardener. One day he slipped and fell on the job. Marc complained of associated pain that left him unable to work any longer and filed a worker’s compensation claim. The process went quite smoothly and it didn’t take long for Marc to start receiving his disability benefits. However, unbeknownst to Marc, the insurance company was on his trail. After seeing surveillance video showing Marc actively doing yard work for two other properties, Marc was called to task. Not only would the disability checks be curtailed, but he was sentenced to four months in prison and ordered to pay over $39,000 in fines.
2. Jack complained about injuries he sustained at work. He said the resulting back pain made it impossible to continue his work. Jack told the attending physician that he had not experienced any pain prior to his occupational injuries. It didn’t take long for the insurance company to provide proof that Jack was lying about his inability to work. The surveillance camera caught him working as a landscaper in the family business after the claim he made, resulting in 3 years in prison and a $14,500 fine.
3. Sarah filed a workers’ compensation claim after she injured her back and leg while walking up a slope at the company’s outdoor facilities. When she applied, Sarah failed to count on the ability of the insurance company’s investigation department. The department’s thorough work revealed the true nature of the injuries: the injuries had occurred before the date listed on the claim, as did the discussions colleagues had with her about them. Sarah got 120 days in jail, plus 5 years probation, plus a $28,000 fine!
