Although there are many warning signs of workers' compensation claim-related fraud, experience shows that when two or more of the following factors are present in a claim, there is a greater chance it may be fraudulent. Agents can help protect their clients from claim-related fraud by helping them look out for the following red flags:

Monday morning reports: The alleged injury occurs first thing on Monday morning, or the injury occurs late on Friday afternoon but is not reported until Monday.

Suspicious providers: An employee's medical providers or legal consultants have a history of handling suspicious claims, or the same doctors and lawyers are used by groups of claimants.

Conflicting descriptions: The employee's description of the accident conflicts with the medical history, the first report of injury, or other witness statements.

Treatment is refused: The claimant refuses a diagnostic procedure to confirm the nature or extent of an injury.

Claimant is hard to reach: The allegedly disabled claimant is hard to reach at home.

Employment change: The reported accident occurred immediately before or after a strike, job termination or layoff at the end of a big project or at the conclusion of seasonal work.

No witnesses: There are no witnesses to the accident and the employee's own description does not logically support the cause of injury.

History of claims: The claimant has a history of a number of suspicious or litigated claims.

Late reporting: The employee delays reporting the claim without a reasonable explanation.

Changes: The claimant has a history of frequently changing physicians, changing addresses and numerous past employment change

Policyholders suspecting potential claim-related fraud should be advised to reach out to their carrier's fraud investigation unit immediately.

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Insurance agents are on the front lines against workers&rsquo; comp fraud

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Insurance agents are on the front lines against workers’ comp fraud