May 14, 2019

8 Ways to Prevent Fraudulent Claims

8 Ways to Prevent Fraudulent Claims

Fraudulent claims increase costs for everyone. You need to create a company culture where employees feel valued and where they make safety a top priority. When employees feel safe, valued, and listened to, they are less likely to submit fraudulent claims.

1. Carefully Vet Each Employee

Conducting rigorous background checks for new hires helps create an ethical base of quality employees. Be certain to:

  • Verify employment history and eligibility.
  • Make copies of ID cards, certifications, etc.
  • Check references.
  • Update and maintain current records of all employees.

2. Show Employees That You Care

On the first day of work, employees should be educated about their benefits, including: private health insurance, workers’ compensation, and state disability. It is vital that employees are informed of these protections to help them know they are valued. To continue to support their workers, employers should:

  • Listen to complaints about poor treatment or unsafe conditions.
  • Provide guidance and explanations on the workers’ compensation process.
  • Follow up with injured workers to ensure their fair and proper treatment.
  • Provide a hotline for anonymous reporting.
  • Improve employee morale by providing swift resolutions to complaints.

3. Provide Thorough Manager Training

It is essential that managers are equipped with the appropriate knowledge, skills and routines to handle claims. Regular training will ensure that managers and supervisors understand and can easily follow the claims process.

  • Confirm that managers understand the workers’ compensation process.
  • Train managers in proper injury investigation technique.
  • Document ALL complaints of injury, even if the worker denies treatment.
  • Report all injuries to PIASC Claims Coverage.

4. Communicate Zero Tolerance for Fraud

As part of the on-boarding process, new employees should be introduced to the zero-tolerance policy for fraud. Not only should this be communicated from the first day, it should be regularly publicized and enforced. Make sure to:

  • Provide new employees with a copy of the anti-fraud policy.
  • Advise that fraud policy will be fully enforced.
  • Explain that every injury will be investigated. Follow through.
  • Review the zero-tolerance policy annually and update as needed.
  • Utilize anti-fraud resources on the PIASC Policyholder Center. 

5. Hold Regular Safety Meetings

Regular safety meetings bring home the importance of keeping injury rates low. To create a culture of safety in the workplace, make sure to:

  • Hold monthly or quarterly safety meetings.
  • Provide training on the importance of reporting injuries.
  • Provide a checklist of steps to take in case of injuries.
  • Explain how to report injuries and make claims.
  • Work with PIASC Risk Management in planning and implementing safety meetings.

6. Include Surveillance as Part of Safety Plan

As part of the safety plan, invest in security cameras to create a safer work environment. In addition, be certain to:

  • Advise employees that security cameras are in place.
  • Explain that cameras will help validate legitimate injury claims
  • Analyze videos of accidents and injuries to help prevent similar occurrences.
  • Maintain video evidence for future analysis.

7. Complete Full Injury Investigations

After accidents are properly reported, the investigation process should proceed according to the plan presented in manager training.

  • Photograph the accident site.
  • Review and analyze surveillance video.
  • Report any suspicions to your carrier or PIASC Risk Management.

8. Conduct Exit Interviews

Most successful companies conduct exit interviews to improve company culture and increase retention. This interview is also an opportunity to review on-the-job safety practices.  During your exit interviews, make sure to:

  • Collect data that will be useful in future safety plans.
  • Ensure that the worker clearly knew how to report an injury.
  • Verify that there were no injuries sustained during employment.
  • Ask the employee to sign a declaration of no injuries.

For convenience, we’ve created a flyer to share with these 8 Ways to Prevent Fraudulent Claims.

About the Author

PIASC is the largest graphic arts trade association in the country. They are devoted in helping members succeed. For over 80 years, they have been servicing businesses in Los Angeles, Orange, Riverside, San Bernardino, San Luis Obispo, Kern, Ventura and Clark counties.

Leave a Comment

Your email address will not be published. Required fields are marked *

Comments (0)

Protect Your Business and Thrive

Get Insurance Review