Is Workers Comp. Fraud Overstated?
As you mention in the article, insurance companies claim that up to 80% of all workers’ compensation claims are exaggerated or overstated. I side with the “critics” who say that fraudulent claims account for less than 5% of total claims. However, due to system complexity, delayed or overlooked treatment and ineffective claim management of legitimate claims, secondary issues such as depression enter the picture, making a successful return to work more difficult. Most certainly, exaggeration or “malingering” in legitimate claims exists. But I do not believe that such claims exceed 10% of all claims submitted. Before you suggest that I am naive, please know that my job involved managing the most difficult and contentious claims in our jurisdiction. I can honestly say that there is very little in terms of misstating and exaggerating of claims that I haven’t seen.
