Fraud Prevention 
Poster: Fraud - Big Nose
Poster: Fraud - Liar Liar
Poster: Preventing Fraud

Be sure you know the warning signs to help prevent fraud.

  1. MONDAY MORNING REPORTS: The alleged injury occurs first thing on Monday morning, or the injury occurs late on Friday afternoon but is not reported until Monday.
  2. SUSPICIOUS PROVIDERS: An employee’s medical providers or legal consultants have a history of handling suspicious claims, or the same doctors and lawyers are used by groups of claimants.
  3. CONFLICTING DESCRIPTIONS: The employee’s description of the accident conflicts with the medical history or first report of injury.
  4. TREATMENT IS REFUSED: The claimant refuses a diagnostic procedure to confirm the nature or extent of an injury.
  5. CLAIMANT IS HARD TO REACH: The allegedly disabled claimant is hard to reach at home.
  6. EMPLOYMENT CHANGE: The reported accident occurred immediately before or after a strike, job termination, layoff, end of a big project or at the conclusion of seasonal work.
  7. NO WITNESSES: There are no witnesses to the accident and the employee’s own description does not logically support the cause of injury.
  8. HISTORY OF CLAIMS: The claimant has a history of a number of suspicious or litigated claims.
  9. LATE REPORTING: The employee delays reporting the claim without a reasonable explanation.
  10. CHANGES: The claimant has a history of frequently changing physicians, changing addresses and numerous past employment changes.