Why Employee Comp Fraud Doesn’t Pay

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, a company is required by law to obtain workers’ compensation coverage so that employees can claim benefits in the event that they suffer a work-related injury.

So it’s a fact – employee comp is an important factor in any company’s insurance portfolio.

The problem lies when an employee makes a fraudulent claim. And unfortunately it happens quite often. But contrary to popular belief, employee comp fraud affects not only companies and bosses, and the employees who go through life in a completely honest way, but also the faker. File a fake employee claim and you risk losing your job, spending time behind bars and paying expensive fines. Trust those in the industry: crime – when it comes to workers compensation – certainly doesn’t pay!

Below are some examples of employees who thought they could make some money by fooling the system. In the long run, the hoax turned against them.

Fake Worker Compensation – True Scenarios

1. Marc worked as a gardener. One day he slipped and fell at work. Marc complained of the accompanying pain that left him unable to work, and filed a complaint for employees. The process went quite smoothly and it didn’t take long for Marc to receive his disability benefits. But unbeknownst to Marc, the insurance company was on his trail. After watching surveillance videos showing Marc actively gardening for two other properties, Marc was approached. Not only would disability checks be curtailed, but he was sentenced to four months in prison and ordered to pay more than $39,000 in fines.

2. Jack complained about injuries he had sustained on the job. He said the resulting back pain made it impossible to continue his employment. Jack told the attending physician that he had been in no pain prior to his work injuries. It wasn’t long before insurance provided proof that Jack was lying about his disability. The security camera caught him working as a landscape gardener in the family business after the claim he filed, resulting in a 3-year prison term and a $14,500 fine.

3. Sarah filed a disability claim after sustaining injuries to her back and leg while climbing a slope at the company’s outdoor facilities. When filing, Sarah did not take into account the assets of the insurance company’s investigative department. The department’s thorough work revealed the true nature of the injuries: the injuries had been incurred before the date stated on the claim, as well as the discussions colleagues had with her about them. Sarah was jailed for 120 days, plus 5 years of probation, plus a $28,000 fine!