Questionable Workers Compensation Claims on the Rise

September 25, 2013

National Insurance Crime Bureau

The total number of workers' compensation claims across the nation is dropping but the number of questionable claims is rising, according to a new study.

Over the last 2 1/2 years, the number of workers filing compensation claims has dropped from 3.35 million in 2011 to 3.24 million in 2012, according to the National Insurance Crime Bureau, a nonprofit company supported by more than 1,000 insurance companies.

Based on claims filed in the first half of this year, the number is on track to drop again, the bureau said.

But in the same period, questionable claims have risen from 3,474 in 2011 to 4,460 in 2012 and are on pace to rise again in 2013, the bureau reported Tuesday.

California had the largest number of questionable workers' compensation claims each year, but when ranked by claims per 100,000 residents, Delaware came out at the top of the list in 2011, Connecticut ranked first in 2012, and Maine ranked first in the first half of 2013.

Among cities, Chicago had the largest number of questionable claims in 2011, and Los Angeles took the top spot in 2012 and in the first half of 2013, the report said.

Among the most common workers' compensation fraud cases are workers faking or exaggerating injuries, or filing for injuries that did not take place at work, the report said.

This is a classic case of good news-bad news. At a time when the market is hardening, rates continue to rise, and payrolls are going up, decreasing number of workers compensation claims could spell some relief for employers. The bad news is that fraudulent workers comp claims can be a real detriment to your premium costs. Fortunately for employers, workers compensation premium recovery offers a way to recover overcharges and receive refunds on current and prior years' policies. It takes an employer 5 minutes to sign up, and refunds and credits will follow a few months thereafter. The contingency fee means that this service will cost nothing unless the employer receives a check, credit, or reduced premium in hand!