Preventing Fraud and Abuse – Constant Vigilance
Keenan has always integrated the prevention of fraud, waste and abuse into our workers’ compensation programs because they add significantly to the cost of providing benefits and services to those who have legitimately been injured on the job. As part of our dedication to fraud prevention and prosecution, Keenan maintains a Special Investigation Unit (SIU) to detect, investigate and assist with prosecution of fraudulent activity. Our SIU has an excellent record working in cooperation with District Attorneys throughout the state in achieving convictions against those who abuse the system. We just recently obtained another conviction for fraud in Santa Barbara County.
Unfortunately, workers’ compensation fraud has been on the rise. The recent economic environment, the mortgage meltdown, government cutbacks and rising student debt are factors leading people to commit fraud and abuse. Some see the workers’ compensation system as a solution to their financial challenges, consider it easy money and are simply clueless to the potential consequences. There are also plenty of examples of sophisticated cases that require careful and persistent digging.
In the recent issue of National Underwriter’s FC&S Legal we published an article detailing the keys for successful fraud investigation and prosecution. Understanding the red flags indicating potential fraud, following best practices for investigation and effectively publicizing successful prosecution combine to create a strong deterrent in protecting employers’ workers’ compensation programs and reducing costs.
About Stacey Golden
Stacey Golden is the Director of Claims/SIU in the Integrated TPA division for Workers’ Comp. She enjoys speaking at conferences and providing training for Keenan.