Referrals for comp fraud increased in first half of '09, report finds

Workers' compensation fraud increased slightly during the first half of 2009, according to a review of suspicious claims referred by insurers to the National Insurance Crime Bureau.

The bureau's data found a 2 percent overall increase in workers' comp fraud referrals compared to the first half of 2008. Duplicate billing accounted for the largest jump in workers' comp referrals with a 100 percent increase over the first half of 2008. Referrals indicating medical provider wrongdoing -- duplicate billing and inflated medical billing -- accounted for 3 percent of the total number of workers' comp referrals during the first half of 2009.

The study also found that referrals for false loss statements increased 55 percent. In addition, fraudulent disability referrals jumped 32 percent. Incidents involving claims filed for nonwork-related injuries increased 17 percent and cases of employees working while collecting comp benefits rose 10 percent.

NIOSH: Promote work-family balance to reduce workplace injuries (10/29/12)
Proposed survey targets asthma among health care workers (07/26/12)
Report outlines effective strategies for successful self-insurance groups (06/18/12)
Louisiana signs on to put a stop to misclassification of employees (03/05/12)
Oklahoma governor signs comp reform legislation (06/16/11)

The news wasn't all negative, officials said. Referrals for premium fraud fell 21 percent during the first half of the year.

Bureau officials said data indicated an increase in nearly all referral categories -- including property, casualty, vehicle and commercial -- compared with the first half of 2008.

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September 28, 2009

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