Workers’ compensation fraud is a growing problem, which adds billions to the cost of everything we buy.
The National Insurance Crime Bureau (NICB), which investigates and tracks insurance fraud nationally, estimates that workers’ compensation fraud costs businesses, and ultimately all of us, $5 billion per year. One of every 10 dollars spent for premiums to cover the real injuries suffered in the workplace is estimated as lost due to fraud.
The most common kind of phony occupational injury is one that is used in workers’ compensation fraud. This could take the shape of an entirely made-up injury, an actual injury sustained outside of the workplace, or an actual injury whose severity is prolonged to prevent going back to work.
False workplace injuries are just one aspect of the larger problem of workers’ compensation fraud. In order to gain reduced premium rates, employers who mislead the insurer about the number of employees covered, prior injury claims, or the actual sort of work performed are committing fraud.
Workers’ compensation fraud schemes also frequently involve medical provider fraud. Medical providers commit insurance fraud when they falsely certify disability claims or bill workers’ compensation insurers for medical services not actually provided.
Now, a video showing a Fort Lauderdale office worker apparently smacking herself in the head with a piece of a broken sprinkler head, Sheyla Veronica White, 51, of Pembroke Pines, was accused of workers’ compensation fraud in July 2016 after her claim was filed and then challenged.
While working as a receptionist at Cinque Terre Energy Partners in October 2015, White filed an injury claim indicating that part of a sprinkler from a fire suppression system fell from the ceiling, bounced off her desk, and struck her in the head, according to a report.
When the claim was investigated after being challenged by the company’s insurer, footage from Cinque Terre’s security cameras showed something else.
The arrest report claimed that the video showed the sprinkler piece falling onto her desktop, but not hitting her. “White then picked up the sprinkler piece, looked at it, scouted the immediate area for witnesses [and] then intentionally struck herself on the forehead with the fixture.”
The WSVN 7 report that White was charged with workers’ compensation fraud, a third-degree felony, rather than getting monetary compensation, Ironically, White hardly had time to heal from her self-inflicted wound before the Broward County Sheriff’s Office escorted her away in handcuffs, and took her picture for a mugshot.
Luckily, she wasn’t required to pay restitution since she was caught before she could collect any payments from her insurance company. White was then sentenced to 18 months of probation for her crime.
In a report by FOX 13, White was found out after the insurance provider for her workplace became suspicious about the occurrence and got in touch with Florida’s Division of Investigative and Forensic Services. Detectives subsequently acquired security camera footage, which demonstrated that White had fabricated the injuries.
Although this particular crime appears to have no victims, LT. Doreen Rivera noted that it is this abuse that harms other employees. Employees are legally obligated to purchase insurance for workers’ compensation, and false claims drive up the cost of their coverage.
Lt. Rivera explained, adding her department has found the major abusers to be in the construction industry, “Not having it is a felony and not having it is serious. And why is it serious? Because if a worker gets injured on the job and there’s no coverage, they’re going to have to cover their own medical costs and those medical bills can, you know, be staggering,
It’s well identified down south and now it’s emerging here. And that is basically when a business is created for the purposes for taking out a minimal workers’ comp policy,” she said.
Well, in fact, businesses often lie about how many workers they employ or pay a fee to “shell companies” in order to abuse their workers’ compensation insurance instead of purchasing their own for their employees, not only the Employees can scam insurance companies.
Watch the video report below for details: