Employers Liability Fraud – What To Watch Out For

During times of recession and economic downturn, organisations’ employers’ liability insurance is more susceptible to fraudulent claims. Fraudulent employers’ liability claims are often difficult to defend due to the fact that a defence may be prejudiced by the failure of the defendant company to properly provide a safe place or system of work or establish proper reporting and risk management procedures.To help you detect possible employers’ liability fraud and decrease your number of claims, the following is a list of several factors to watch for:

  1. Monday Morning: The alleged injury occurs either “first thing Monday morning” or late on a Friday afternoon but not reported until Monday.
  2. Redundancy:If an employee files a post-redundancy claim was the alleged injury reported by the employee prior to being made redundant?
  3. Medical History: The employee has a pre-existing medical condition that is similar to the alleged work injury.
  4. No Witnesses: The accident has no witnesses, and the employee’s own description does not logically support the cause of injury.
  5. Conflicting Descriptions:The employee’s description of the accident conflicts with the medical history or First Report of Injury.
  6. History of Claims: The claimant has a history of numerous suspicious or litigated claims.
  7. Medical Treatment: The claimant refuses a diagnostic procedure to confirm the nature or extent of an injury. Also, when did the claimant first report the symptoms to his GP?
  8. Late Reporting: The employee delays reporting the claim without a reasonable explanation.
  9. Moonlighting:Does the employee have another paying job or do volunteer work?
  10. Unusual Coincidence:There is an unusual coincidence between the employee’s alleged date of injury and his/her need for personal time off.
  11. Financial Problems:The employee has tried to borrow money from co-workers or the company, or requested pay advances.
  12. Hobbies:The employee has a hobby that could cause an injury similar to the alleged work injury.

Be sure to help reduce the risk of fraudulent claims by creating a competent risk management system and ensuring that all reporting procedures are followed. Also, immediately investigate any reported injury and record all correspondence related to possible claims.

Speak to Bromwall to discuss you employers liability needs.

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