Early in a workers compensation injury, certain actions or errors can indicate a problematic claim. The presence of a red flag, such as a late report or a Monday-morning injury, doesn’t always indicate fraud, but it may mean your insurer should more closely investigate the injury. Here are a few red flags and ways you can help your workers compensation claim process by providing further information.
Late report – Most late-reported claims bear watching. Your employee manual should require same-day reporting. With any late report, insist your insurance company complete a thorough investigation before accepting the claim. You can help defuse negative employee responses by making it clear in your handbook that late reports will generate extra scrutiny.
New-hire injuries – If an injury occurs in the first few months of employment, alert your insurer. Talk with any internal witnesses and the employee’s supervisor to pinpoint any behavioral issues that may affect the claim.
Injuries filed after employment changes – After layoffs, demotions or terminations, employees may file an injury claim. Be sure your insurer understands the circumstances surrounding the employee’s status.
Communicating all the facts of the incident to your insurer can further a team approach to injury management and reduce deceptive claims.
