Fraud, Conspiracy, And Reality Five Danger Signals Of Workers' Compensation Fraud.

• Author: Moll, Arther I.
• Position: VIEWS FROM THE BOTTOM

We must alert our clients to be attuned to the danger signals of fraud. If action is taken early enough, millions of dollars in unnecessary payments will be saved.

We lose at least one job from the workforce for every fraudulent claim that goes undetected. The Workers' Compensation Board indexes more than 200.(XX) cases a year. If 10 percent of these cases are fraudulent, (some experts say that the number of fraudulent claims exceed 25 percent), we could potentially add 20,000 jobs to the very weak economy of New York State.

I'm not deluding myself in believing that this would be an easy task or fully attainable goal. However, if we continue to roll over and play dead and let a few rotten apples spoil the barrel, we all suffer.

Stamping out fraud is difficult at best, but we must at least try to the full extent of our joint capacities.

Carriers, employers, perplexed producers, and organized labor need to join together to eradicate fraud. Fraud prevention is everyone's job.

If we take an aggressive stance against the perpetrators and several illegitimate claimants, lawyers, and providers are sent to jail, this evil practice will diminish slowly but surely.

Here's how we should start:

* Expand the investigation units in the insurance companies so if an employer suspects fraud, the company could make phone calls, initiate surveillance to ascertain the validity of the claim.

* The questioning of providers immediately would send a message that treatment, and invoices arc under careful scrutiny.

* We must send our clients copies of the "Danger Signals" and urge them to be vigilant. Only aggressive action will deter the blood-suckers who are hurting the insurance industry, businesses, labor and the economy in general.

Incursions of the "C"s

There seems to be a trend arising--a concerted effort by three giant "C"s--Chase, Chemical and Citibank--to disregard the law. They appear to believe they are free of legal restraint and are actively soliciting insurance not only from Homeowners, where they arc mortgagees, but also auto insurance. Their latest effort at incursion includes the solicitation of New York Stale disability coverage (DBL). Of course, they couldn't embark on this voyage if they were not joined by the fourth C--the insurance companies who throw loyalty to the wind to do business with the "elite." The banks' credo is: legality be damned--full speed ahead. They are clearly in violation of New York State Law which prohibits banks from...