Builders Insurance Urges Employers to Join the Fight against Workers' Compensation Fraud.

LAS VEGAS -- As construction cools down in Nevada, there is one thing that is starting to heat up: Workers' compensation fraud. To fight this increase, employers must maintain a vigilant eye on both old claims and new claims.

According to Dave Oakden of S&C Claims Services, when lay offs and slow downs occur in the construction trade, the number of workers' comp fraud cases increases, as does the amount of those claims. Oakden handles claims for Builders Insurance Company, one of the two largest workers' comp carriers in the state, and has issued a fraud-alert warning to the more than 1,000 Nevada construction companies covered by Builders Insurance.

"There are 40,000 workers' comp cases that are filed annually in Nevada. Of those, 10 percent are possibly fraudulent," said Oakden. "Employers need to keep an eye out for workers that re-open an old claim before they get laid off. They also need to watch out for workers who hire an attorney before they hit the ground."

Oakden stressed that it's important to do thorough reports on every accident and to interview co-workers who witnessed the incident. "The more detailed you are at the first report of an accident the better your cases of eliminating fraud," he advised employers.

With workers' comp compensation pegged at a maximum of $4,800 a month, the workers' income potential is a lot better than what they can receive from unemployment benefits. And, because of this, some less-scrupulous, less-honest workers will invariably opt to try for the bigger paycheck.

To keep their claims to a minimum, there are a multitude of things employers can do, Oakden noted. "Be on the look out for accidents reported well after they allegedly occurred," he suggested. "Stress to employees that accidents must be reported when they happen, not days or weeks later.

"In addition, look for any inconsistencies in reported cases, such as refusing medical attention, then seeking it out at a much later date," Oakden suggested. "Do drug screenings and look into the possibility that the worker is exhibiting a drug seeking behavior. In these kinds of cases, workers often claim nothing definitive, but claim to have pain everywhere."

Oakden noted that there are other warning signs applicable to fraud cases. "Be wary of spouses who get involved in the case," he noted. "This is a telltale sign that the claim could be suspicious. The claimant has the sole responsibility to handle their own case unless it involves major injury, which makes it impossible for them to do so.

"In addition, watch for employees who play in sports leagues," he said. "It is not uncommon for an after-work sports injury to be reported as an on-the-job accident."

Once an employee has opened a claim, Oakden urges employers to make sure injured employees are doing the light duty assignments they have been approved to handle. Failure to work in their reassigned area or no call/no show for light duty can be red flags for workers' comp.

In the end, Oakden said, workers' comp fraud not only costs money, it is illegal.

"When we discover fraud, we turn the case over to the Attorney General's Office for criminal charges," said Oakden. According to him, Builders Insurance Company is one of the most pro-active carriers in the state when it comes to referring fraud practitioners for prosecution.

About Builders Insurance Company

Builders Insurance Company - BIC - offers post accident drug testing, back-to-work programs and created a drug-free workplace program to save Nevada's construction companies millions in workers' comp costs. More than 1,000 Nevada construction companies look to Builders Insurance to provide comprehensive workers' comp protection to their employees.

Builders Insurance distinguishes itself by providing workers' comp coverage - as well as comprehensive safety and fraud-reduction measures - designed to help participating companies reduce on-the-job injuries and reduce workers' comp claims - and costs.

Builders Insurance Company is a Nevada domestic insurer wholly owned by Nevada Contractors Insurance Company, Inc., a Nevada captive insurer; in turn, Builders Insurance is the sole owner of Risk Services-Nevada, which provides safety training and claims support for Builders Insurance's more than 1,000 policyholder companies. For more information, please visit the web site at http://www.nevada-comp.com.