Almost all faud committed by employers and insurance companies

Author Subject: Almost all faud committed by employers and insurance companies
Del Posted At 19:27:31 07/28/2000
Workers' Compensation Notes: Issue 3, May/June 2000 (There's more at this link below

Washington State Labor Council Slams NBC

On May 29, "NBC Nightly News" and its program "Dateline" chose again to focus on an instance of worker fraud in a workers' compensation claim. Although studies show that claimant fraud in this system is minimal—in California, worker fraud is less than three-tenths of 1 percent of all claims; in Wisconsin, it is less than one-tenth of 1 percent of claims—these exposés, encouraged by irresponsible allegations from the insurance industry, feed the myth that workers injured on the job are frauds, cheats and malingerers.

The Washington State Labor Council wrote to Tom Brokaw to express its dismay at this unfair portrayal of what is really happening in workers' compensation today:

Dear Mr. Brokaw:

Approximately a week and a half ago, you broadcast a report on fraud by an injured worker in California. I frankly do not know whether or not this worker in fact committed fraud. I have no sympathy for workers who defraud the Industrial Insurance system. What is astonishing to me is that your report focused on what is acknowledged by the vast majority of academic experts to be, by far, the source of the lowest amount of fraud in the Industrial Insurance system. In every study that has been done on fraud in Workers' Compensation, employer, insurer and provider fraud are found to be a dramatically greater problem than claimant fraud. At a time when injured workers throughout this nation are suffering enormously from "deform" of the system driven primarily by insurance providers, your report gave a seriously skewed presentation on the problems with the system.

I do not believe you have a serious interest in what is happening to injured workers, but if by chance you do, I urge you to take a look at the recommendations that were made by the National Commission on Workers' Compensation during the Nixon administration (an administration not particularly sympathetic to workers). Then have your staff compare those recommendations to today's reality for injured workers. We should be ashamed of what we are doing to injured workers throughout this nation.

I wish I did not feel cynical about sending you this e-mail. I am sorry that you have bitten the insurance industry bait, hook, line and sinker.

Robert Stern, Special Assistant to the President
Washington State Labor Council, AFL-CIO

More Truth About Fraud in Workers' Compensation

In its Report on Allegations of Workers' Compensation Fraud (Nov.1, 1999), the state of Wisconsin found that over the five-year period from 1994 to 1998, out of an average of 65,000 lost-time injuries per year, insurers reported (as required by law) just 15 fraud allegations per year that were referred to district attorneys for prosecution. Of those 15, there was an average of fewer than three convictions per year. This is far less than one-tenth of 1 percent. The conclusions, according to the state, are that the public's perception of workers' compensation fraud is exaggerated and that the documented level of workers' compensation fraud is minimal.

In California, according to data from the Fraud Division of the Department of Insurance and the insurance-owned California Workers' Compensation Institute, there are approximately 1,000 fraud referrals per quarter and about 60 convictions per quarter out of an average of nearly 70,200 lost-time claims per quarter. Again, the conviction rate for claimant fraud is less than one-tenth of 1 percent. In a report marked "Confidential," the Department of Insurance admits "while the initial anti-fraud enforcement efforts have focused on claims fraud, one area of workers' compensation fraud which has not received adequate attention is premium fraud."

Meanwhile, the 14th Statewide Grand Jury of the Supreme Court of Florida found that, even though it is a felony of the third degree for an employer to knowingly fail to secure coverage for workers' compensation, large numbers of employers make no attempt to buy any insurance at all. According to the grand jury's report (July Term, 1997, Case No. 90,703), the Florida Department of Labor's own figures show that more than 13 percent of employers they contact are without insurance. While those figures are high, the grand jury charged that they understate the magnitude of the problem. It found that "employers who buy no insurance at all are rarely, if ever, referred for prosecution and generally face minimal civil penalties." The problem, the jury told the court, is that "the penalty for being caught without insurance is almost always far less than the cost of insurance itself."
Caroline, TIES Re: Almost all faud committed by employers and insurance companies (Currently 0 replies)
Posted At 15:25:09 08/10/2000

Ernie, lets not forget some attys. and drs. when it comes to fraud. I feel we need to take what action we can in this area too, ergo the survey, which I would like to update. The more names I get on drs. and attys. the more we have to fight with, and in black and white, not just empty complaints, but paper and/or observer backed opinions which gives the charges objectivety, not just subjective opinions. By the way, long time no hear. I don't call due to your busy schedule. Caroline.

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