Employers Workers’ Compensation Fraud in Florida

Headlines regularly scream about the high rate of workers’ compensation fraud. The headlines don’t say that worker fraud, such as fabricating or exaggerating a claim, makes up less than 2 percent of this eye-popping number. Employer fraud, usually one of the frauds discussed below, makes up the other 98-plus percent. When workers commit fraud, insurance companies lose a few thousand dollars. When employers commit fraud, insurance companies lose a few million dollars.

Employers carefully control the narrative and shift blame for workers’ compensation fraud onto injured victims. There’s nothing new under the sun. Employers have done the same thing for over a hundred years. Back then, employers referred to job injuries as “industrial accidents” to shift blame from their dangerous factories to injured workers. Then as now, a Tampa workers’ compensation lawyer stands up for injured victims when no one else will.

Kinds of Employer Insurance Fraud

Large, small, and in-between companies don’t make money by doing what’s right or fair. They make money by minimizing costs. And, to many employers, workers’ compensation insurance is a cost. In fact, it’s an unnecessary cost in their eyes.

The number of job injuries has leveled off in recent years. Furthermore, most states, including Florida, don’t aggressively enforce workers’ compensation insurance laws. Therefore, many companies believe the chances of getting caught are low (few injuries) and the chances of harsh punishment are even lower (lax punishments).

This environment contributes to a number of possible fraud schemes, especially in Florida. Common employer fraud scams include:

• Misclassification: Workers’ compensation laws only clover legal employees. So, many companies misclassify employees as independent contractors. But a court, not a boss, defines the difference between employee and independent contractor.
• Dummy Policy: Insurance companies must have adequate financial resources to do business in Florida. Basically, a company must have enough money to pay a high volume of claims. Undercapitalized “insurance companies,” which are usually offshore companies, often sell worthless “insurance policies” for pennies on the dollar.
• Miscategorization: This scam resembles the misclassification scam.Insurance companies set premiums according to risk. So, a company might claim it employs eighty clerical employees and twenty roofers when the opposite is true.
• Payroll Size: This fact is another key risk element. Once again to fraudulently reduce premium payments, some companies like about their payroll size on insurance forms. Other lies include not listing WFH employees as employees and not keeping up with premium payments.

A false promise of benefits isn’t insurance fraud as such, but in most cases, it has the same effect. That’s why so many companies use it.

After a workplace injury, some employers promise to pay benefits under the table if the worker doesn’t file a claim. If the employer reneges on this promise, and it usually does, the claims filing deadline has passed, leaving the victim with nothing. If the employer follows through, which occasionally happens, injured workers still lose. Premiums don’t increase accordingly so there’s less money in the system.

On a related note, it’s illegal to fire someone for collecting workers’ comp, filing a claim, or encouraging someone else to file a claim.

Your Legal Options

A few final words about legal options in what Tampa workers’ compensation lawyers call nonsubscriber cases (an uninsured employer).

Usually, filing a civil suit is the best option in these cases. Since the employer skirted the law and didn’t buy proper insurance, the employer usually cannot use some key negligence defenses, like comparative fault, in court.

Social Security Disability is an effective Plan B in many cases. These benefits are available, regardless of cause, if the applicant has a disabling injury or medical condition.

 Work With a Highly-Skilled Hillsborough County Lawyer 

Injury victims are entitled to important financial benefits. For a confidential consultation with an experienced workers’ compensation lawyer in Tampa, contact Kobal Law. Virtual, home, and after-hours visits are available.

Source:

employers.com/blog/2014/workers-compensation-insurance-fraud-101-presentation/