It's a safe bet that people have been looking for ways to defraud their insurance companies since the invention of insurance. When it comes to insurance scams, workers compensation may be one of the biggest temptations around. With contractors making up a sizable percentage of its business, Florida might seem a likely hotspot for workers' compensation racketeering. Nonetheless, the state has kept its rates of insurance fraud fairly flat in recent years, thanks to strict penalties and a variety of enforcement avenues.

In 2010, Florida's insurance analysts observed a slight shift in the kinds of fraud being perpetrated. They had anticipated that the recession might be a catalyst to an increase in unsupportable claims, but that turned out not to be the case. Instead, fraud investigators noticed an uptick in the number of claims misrepresenting prior medical history. These trends represented a change from previous fraud patterns, which primarily entailed workers' receiving disability pay while working another job, as well as compensation benefits for undocumented employees. Insurers also reported discrepancies in payroll numbers and employee classifications.

On a broader scale, some cooperative frauds involve the renting of workers' insurance certificates for profits. Others entail dummy companies working in cahoots with check-cashing agencies to defraud insurance companies, a scheme that results in millions of dollars of losses for the insurers and legitimate employers.

One of the reasons Florida's rates of fraud claims remains relatively steady is its strong network of enforcement and investigation units. Many insurance companies have their own internal divisions dedicated to fraud detection while others outsource the work. The president of an independent investigation firm based in St. Petersburg described his company's offerings: “Companies such as ours offer a variety of services, including surveillance, background checks, and claim investigations.” He went on to note that about three-quarters of the claims they look into turn out to be false.

Education is a key component in keeping fraud rates low. The insurance industry also provides resources for preventing fraud by offering informational seminars and materials to adjusters on fraudulent practices.

Despite the tough enforcement and stiff penalties, many workers compensation fraud cases go unpunished. A recent estimate showed that about one dollar out of every 10 dollars paid in workers' comp premiums is lost to fraud. Insurance fraud has to be prosecuted in criminal court, where the burden of proof is guilt beyond a reasonable doubt – a burden that is sometimes too difficult to meet. Nonetheless, Florida remains a credible case study in the cooperation of insurance companies, legislators, investigators, and businesses in preventing and detecting this widespread crime.

About the Author

Mary Wiglue Workers Compensation Florida - For your questions about workers compensation in Florida, you need immediate answers. The Law Offices of Jason G. Barnett are keenly aware of the tactics used by the insurance companies and employers you're up against. Don't lose your entitlement to benefits that are rightfully yours. We are a work injury law firm that will fight for your rights. Call 888.854.8700 or visit http://barnettlawyers.com/

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