How Will Safety Pays Help With Fraudulent & Post-Termination Claims?

Frankly, when Safety Pays was developed, fraudulent claims were not a primary target. After all, how does one impact an individual who no longer works for the company? That particular problem simply didn't seem to be something an incentive program could address given the fact that a former employee is no longer there to be motivated. Right? Wrong.

At the company where Safety Pays was developed, the philosophy was to provide a mechanism for the workforce to take ownership of injuries that happened and helping co-workers return to work on a timely basis.

We believe that once this occurred, it would become socially unacceptable to do anything which would negatively impact one's co-workers. In fact, this has been demonstrated thousands of times by numerous Safety Pays client companies over the past 20 years.

For example, one client reported an employee who came up to a supervisor' office one morning holding his arm as though he'd sprained it. He told the supervisor he'd slipped in the freezer and twisted his arm in the fall and so was immediately sent to the clinic for a check-up.

Within an hour, 3 other employees having heard what happened, separately approached the same supervisor to say that they had been in the freezer the entire time with the individual who was allegedly injured and that at no time did he slip or fall.

Furthermore, they volunteered to have their declarations taped by the insurance carrier! Never before had this company's employees ever stepped forward to speak against a co-worker much less volunteer to testify.

Another Safety Pays user reported how a terminated employee who had claimed a phony back injury was spotted bowling regularly at a neighborhood bowling alley by two co-workers who immediately brought this information to the attention of the company's management so that a sub rosa undercover check could be done.

What's equally important is the fact that employees who participate in the Safety Pays program become motivated to bring this kind of information to management's attention simply because the fraudulent act now affects them!

In fact, any unfair or fraudulent actions taken by a co-worker (terminated or otherwise) are inevitably going to be discussed amongst the employees themselves. The "group conscience" always leads members of the group to "do the right thing" and let a company's management know what's going on.

It's both fascinating and encouraging to see the indignation felt about a former employee who is trying to take advantage of the company by that employee's co-workers. Because the group incentives serve to make our employees feel as though they are an integral part of the effort to avoid claims, they in turn feel taken advantage of whenever a fraudulent claim occurs.

In clinical terms, the concept at work here is what's called "a chilling effect". Due to the program's success in creating such a healthy peer group environment, people who might otherwise try to get something for nothing using the worker's comp system now have to think twice.

They know they're being watched not only by management but also by their co-workers...and that even goes for former employees. It's sort of like a team member who goes to play for another ball club. If that person departs under questionable circumstances, he is always suspect in the eyes of his former teammates.

So even those individuals who leave the company remain motivated not to take advantage. They know that should a phony claim be filed, they are placing themselves in jeopardy of being caught and identified not just by management but by their own peers.

Obviously, there's no guarantee that every employee will be positively impacted this way. But again, just consider the economics: If just one terminated employee is foreclosed from filing a fraudulent claim during a given policy year, consider those savings alone!

The medical cost will range from $10,000-$20,000, not to mention comp, disability and rehab costs. Such a claim inevitably involves the participation of an attorney. And don't kid yourself, the carrier will almost always settle the claim rather than fight it.

So if through the use of incentives that fraudulent claim is avoided, the company has covered its incentive costs for the entire workforce at a ratio of at least 10 to 1!

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