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Overall reports of workers' comp fraud fell 9 percent in first half of 2010

Referrals for suspected cases of workers' compensation fraud during the first half of the year dropped 9 percent over 2009 numbers, according to a study by the National Insurance Crime Bureau.

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The report highlighted questionable claims filed in the first half of 2010. These are claims that NICB member insurance companies refer to the organization for closer review and investigation based on one or more indicators of possible fraud. Researchers said a single claim may contain up to seven referral reasons. In addition to workers' comp, the report examined five other referral reason categories of claims -- property, casualty, commercial, vehicle and miscellaneous.

Overall, the study found that there was a 14 percent increase in questionable claims in four of the six categories in 2010 when compared to the first half of 2009. However, questionable claims in workers' comp dropped to 2,027, an overall decline of 9 percent from last year. The categories "prior injury/not related to work," "claimant fraud," and "working while collecting" all showed decreases between the first half of 2009 to 2010. Together, researchers said they account for 72 percent of the workers' comp referral reasons.

Not all categories saw a decrease during the first half of 2010. Referrals for "false mileage reimbursement" accounted for the largest percent increase with 100 percent. However, researchers said that referral reason was not used often, representing only 0.4 percent of the total workers' comp referrals for the first half of 2010.

Read more at the WorkersComp Forum homepage.

September 16, 2010

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