How Fraud Inflicts a Heavy Toll on the Workers Compensation System

Overview

Fraud in the workers compensation arena is pervasive, costly, and enormously wasteful. Yet, it persists. It's acknowledged, it's not particularly well-concealed, and its impact cannot be overstated. Caring for the injured worker is not only the right thing to do, but there is also evidence to suggest that doing so well and immediately has the benefit of reducing long out-of-work periods. Focusing on medical fraud, this course seeks to identify risk factors for medical-related fraud and to encourage practices that deter this fraud.

Learning Objectives

Upon completion of this course, you should be able to:

  • recognize that not all medical treatment suggested or requested by the treating physician may be necessary or beneficial
  • recognize indicators of fraud, such as duration of treatment and CPT codes used by the treating physician
  • recognize that individual claimant fraud may be symptomatic of a broader problem for an employer
  • identify options to combat fraud

Designed For

P/C producers; adjusters
International Risk Management Institute, Inc. (IRMI) is the premier provider of risk and insurance continuing education and reference publications, and is considered the ultimate authority by leading insurance practitioners. Written by industry experts, IRMI courses provide the most up-to-date, practical and reliable information possible.
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