Workers Comp Corner is sponsored by National Financial Partners: For more information or rates on Workers’ Compensation or any other business insurance contact Chuck Rose at National Financial Partners, 802-775-4443 or [email protected]
www.nfp.com/poulos
Understanding Misclassification, Miscoding & Fraud Part 4 of 4
Employers who comply with the state’s labor laws should not be put at a competitive disadvantage by businesses that do not adequately insure their employees.
This is why the Department takes seriously accusations of misclassification, miscoding, and fraud committed by employers doing business in Vermont.
A team of trained investigators and attorneys is prepared to respond promptly to complaints filed with the Department. Click here to complete a complaint form.
Our staff will shut-down non-compliant businesses and impose civil penalties, as necessary, but the Department’s primary goal is to educate employers of their legal responsibilities and achieve voluntary compliance. In some cases of non-compliance, the Office of the Attorney General may also seek criminal penalties.
Fraud
Fraud means intentionally lying or making a false statement in order to obtain a workers’ compensation benefit.
Sometimes fraud occurs when someone lies about a material fact in order to affect someone else’s obligations or benefits.
Fraud may be committed by any party or interest to a workers’ compensation policy or claim. This includes but is not limited to the following:
- Injured worker
- Employer
- Physician
- Adjuster
- Insurance agent
- Vocational counselor or
- Any other individual who has an opportunity to influence a workers’ compensation insurance policy or claim
There are three elements to fraud:
- Must be willful; intentional or deliberate; and
- Involves a misrepresentation or lie; and
- Made for the purpose of obtaining a benefit.
It is necessary for all three elements to be met in order for action to rise to the level of “fraud.”
For more information about Workers’ Compensation Fraud, click on Insurance Compliance & Misclassification.
