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Red Flags Suggesting
Workers’ Compensation Fraud

Fraud in workers’ compensation is a growing problem, costing public employers – and taxpayers- thousands of dollars annually. MIIA takes fraud and the abuse of the workers’ compensation system seriously. Our best weapons in fighting fraud are our municipal employers.

Below is a list of Red Flags that may indicate that a particular claim is fraudulent. If one or more of these indicators are present, or if you suspect fraud, contact the MIIA Workers’ Compensation Claims Unit at 1-800-266-6442. We will investigate the case and take the appropriate action.

Red Flags

The accident is not reported promptly.

 
Details of the accident are vague.
There are no witnesses to the accident.
There are discrepancies in the injured worker’s story.
The accident occurs in an area where an employee would normally not be working.
The claim is reported on a Monday.
The injured worker is a new employee.
The injured worker is a disgruntled employee or one on the verge of being fired.
The injured worker is having financial difficulties.
The injured worker is never home or his/her spouse or relative answers the phone call and indicates that the injured worker will call back in a few minutes.
The injured worker inquires about a settlement early in the life of the claim.
The injured worker does not show up for medical appointments.
A tip is received that the injured worker is employed elsewhere or is engaging in an activity inconsistent with the injury.

If one or more of these red flags are present it may constitute fraud. Please call, MIIA Workers’ Compensation Claims Unit at toll free 1-800-266-6442

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