
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, October 29, 1995                   TAG: 9510270107
SECTION: BUSINESS                    PAGE: F3   EDITION: METRO 
SOURCE: HELEN R. MACLEOD JOURNAL OF COMMERCE
DATELINE: NEW YORK                                 LENGTH: Medium

INVESTIGATORS NET A RECORD NUMBER OF ATTEMPTED WORKERS COMP FRAUDS

A record number of employees were caught with their hands in the corporate cookie jar this year with fraudulent workers compensation claims, according to a new report from the National Insurance Crime Bureau.

The NICB said 103 individuals were charged with involvement in workers compensation schemes as of Oct. 1, 1995, compared with 99 for all of 1994. And with 650 workers compensation investigations still open, the total could grow.

The NICB reckons that workers compensation fraud cost the insurance industry $5 billion in bogus claims and lost premiums last year.

Nearly 10 percent of U.S. adults say it's all right for someone injured at home to claim their injury is work-related in order to collect workers compensation benefits, according to research conducted by the Wheaton, Ill.-based Insurance Research Council, an allied agency with which NICB shares information.

``Today's con artists will try anything - from staging a robbery to severing a finger - to collect a quick buck,'' said John Di Liberto, NICB's president and chief executive officer. ``But consumer awareness and quick investigative actions are catching them in the act.''

The most common kinds of workers compensation fraud detected by the NICB included cooperating with dishonest professionals to collect benefits for exaggerated or nonexistent injuries, working a second job while collecting benefits from another employer and claiming a nonwork-related injury was sustained on the job to collect benefits.

``Several years ago, insurance fraud wasn't prosecuted as aggressively as other crimes,'' said Di Liberto. ``Today, people know just how seriously insurance fraud affects the cost of doing business. As a result, more workers compensation schemers are being targeted, caught and prosecuted.''

Because of the introduction of a no-fault clause in workers compensation legislation in most states, meaning compensation no matter what the cause, it became less common to investigate the details of an injury, making the system more vulnerable to fraud. The NICB says the workers compensation system is rightfully biased toward the injured worker. ``The worker is given the benefit of every doubt in the claims process, making fraudulent claims easier and more lucrative,'' the bureau's report, ``Fraud on the Job'' says.

Ring activity, with organized groups of criminals connecting in order to enact systematic fraud, is possible with workers compensation, just as it is with other kinds of insurance, such as car theft.

The NICB advises employers to be wary of a worker who reports an injury if that worker is about to be fired or is disgruntled; or if the worker is in seasonal work that is about to end; or if the worker is having financial difficulties. It also advises employers to ask an employee leaving the company to sign a form attesting that they have not been injured in the workplace in order to reduce exposure to future claims.

by CNB