Challenging questionable claims
When it comes to doubtful claims, there are two categories: claims that, while legitimate, the employee is not entitled to compensation, and those you suspect or know are fraudulent or exaggerated.
"If you are going to make any allegations about a claim being illegitimate, fraudulent or otherwise, then you need to make sure that you have a factual basis for making that allegation," says Murphy.
"Simply suggesting or making an allegation that a claim is fraudulent or illegitimate without having the evidence to do so is inappropriate and it won't get you anywhere."
If you decide to proceed with challenging a claim, investigate thoroughly, and be sure to gather and pass any evidence along to the insurance company as quickly as possible. They will then take it into account when assessing the claim.
"Don't just rely on the insurer to do the investigation themselves. They're not necessarily focused on the same things you are," says Murphy.
In the event you don't have the evidence to support a concern about a claim being illegitimate, it's important to let it go, treat it as legitimate, and move on. "That way you'll be able to get on with business, and that's what's more important," says Murphy.
Managing a remote workforce presents a number of challenges, especially when it comes to workers’ compensation where the risks of a claim occurring are greater. Remember that the principles of overseeing and challenging claims remains the same, regardless of where the individual works.
To learn more about covering your employees with workers' compensation, watch ABLA's free webinar.