The risks and exposures faced by the construction industry are complex and unique. At the annual IRMI Construction Risk Conference, these issues are discussed by industry experts to ensure you have the latest-and-greatest insider insights.

Documentation Is Key to Mitigating Workers’ Compensation Fraud

Workers’ compensation insurance fraud is a big problem in America today, with tens of billions of dollars in false claims and unpaid premiums every year. Identifying and defending against a fraudulent workers’ compensation claim starts with prompt claim reporting and document collection. These are the types of documents that will aid an adjuster:

• Names and contact information of witnesses, including any party related to the event, such as the injured person, supervisors, coworkers, and others.
• Signed statements from each witness with detailed recollections of the alleged injury.
• Photos of the injury (if pertinent).
• Photos of different angles of the area where the alleged injury occurred.
• Videos of the conditions of the work area at the time of the alleged injury (if possible).
• Medical records from the initial medical facility or occupational clinic treating the worker.
• Results of any pertinent drug tests.
• Recommended work restrictions for the injured worker.

Effective documentation gathering is both a useful tool and an important first step in uncovering any fraud in a workers’ compensation claim.

This tip was provided by Melissa Schultz, Patrick Duggan and Brian Koch in the "Identifying and Defending a Fraudulent Workers’ Compensation Claim" session at the IRMI Construction Risk Conference.

See the full agenda for IRMI CRC 2019