Interested in training for your team? Click here to learn more

Workers' Compensation Fraud: Red Flags, Conducting Investigations, Defense Strategy, Best Practices for Prevention

A live 90-minute CLE video webinar with interactive Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Tuesday, November 19, 2024

1:00pm-2:30pm EST, 10:00am-11:30am PST

or call 1-800-926-7926

This CLE webinar will provide a comprehensive overview of workers' compensation (WC) fraud and the impact it has on businesses. The panel will examine who commits WC fraud and what to look for as signs of fraud. For counsel representing employers and insurance companies, the panel will address how to investigate potential WC fraud and what needs to be demonstrated to make a fraud claim. The panel will also discuss how to defend a party against a fraud claim.

Description

WC fraud costs businesses billions of dollars each year. Fraud can be perpetrated not only by employees, but also employers, insurance companies, and healthcare providers.

Common types of fraud committed by employees include faking or exaggerating injuries, claiming injuries are work-related when they occurred elsewhere, or continuing to receive WC payments after they are healed. Employer fraud includes knowingly altering the facts of an injury to avoid paying a claim or underreporting wages or misclassifying employees to lower WC insurance premiums. And healthcare providers commit fraud when inflating medical bills or billing for services not rendered.

Investigations into potentially fraudulent WC claims are triggered by certain red flags, and when fraud is found to have been committed could result in serious penalties including criminal charges, hefty fines, and restitution.

Listen as our expert panel provides a comprehensive overview of WC fraud. The panel will examine what constitutes WC fraud, red flags that may signify fraud, and how to conduct a fraud investigation. The panel will also discuss what needs to be demonstrated to make a fraud claim and examine how to defend a party against such a claim.

READ MORE

Outline

  1. Introduction
    1. Parties who commit WC fraud
    2. Types of WC fraud
    3. Impact of WC fraud on businesses
  2. Conducting WC fraud investigations
    1. Red flags in a WC claim
    2. Methods for detecting fraud
    3. Proving a claim is fraudulent
  3. Defending WC fraud claims
  4. Penalties for committing WC fraud
  5. Best practices for preventing WC fraud
  6. Practitioner takeaways

Benefits

The panel will review these and other key considerations:

  • Who commits WC fraud?
  • What activities constitute WC fraud? What are red flags that signify fraud may be occurring?
  • What are best practices for conducting a WC fraud investigation?
  • What must be demonstrated to make a WC fraud claim?
  • What are the potential penalties for committing WC fraud?

Faculty

MacAlister, James
James K. MacAlister

Attorney
Cohen, Snyder, Eisenberg & Katzenberg

Mr. MacAlister has represented workers injured on the job or those who suffer occupational diseases since 1990. He...  |  Read More

Troy, Matthew
Matthew J. Troy

Partner
Conroy Simberg

Mr. Troy represents employers, carriers, TPAs, uninsured employers, PEOs and self-insured funds in all types of...  |  Read More

Attend on November 19

Cannot Attend November 19?

You may pre-order a recording to listen at your convenience. Recordings are available 48 hours after the webinar. Strafford will process CLE credit for one person on each recording. All formats include course handouts.

To find out which recorded format will provide the best CLE option, select your state:

CLE On-Demand Video