The medical bills reflect a retroactive disability or postdated maximum medical improvement dates. The medical bills reflect inflated impairment ratings. Workers' compensation claims contain white-out. Workers compensation claims are photocopies. In addition to the hints listed above regarding workers' compensation fraud, insurance industry personnel also should be aware that dishonest adjusters have been known to create phony claimants and collect small payments they themselves have authorized.
Adjusters can also increase benefits to an existing claimant for a kickback on part of the increase.
Note that when benefits extend over several years, unscrupulous employers can use the system to supplement the wages paid to injured workers who can legitimately return to work. In addition, dishonest agents collect the premium from employers for workers' compensation benefits and pocket the premium rather than turning it over to the insurer. Sometimes, crooked agents certify phony insurance policies and premium finance agreements to defraud a premium finance company. Finally, a leasing company may falsify the number of client companies for which the leasing company provides workers' compensation coverage. The leasing company profits by collecting more in alleged premiums than they pay to their insurance carrier while certifying coverage to all their client companies.