The key to managing workers’ compensation claims is getting a detailed and accurate first report of the accident and sticking with it.
“The first report is the best report,” said Dan Schwartz, an attorney who litigates claims for Nevada Contractors Insurance, the second largest workers’ comp carrier in the state of Nevada.
Nevada Contractors Insurance held a seminar about workers’ comp claims management for human resource people, foremen and supervisors in Las Vegas. One of the areas discussed was spotting suspicious claims, and Schwartz said that the first report of the accident is one of the best tools to fight fraud.
“That’s the report made when the accident occurred, that’s the report made by the injured worker, the foreman, the supervisor and any witnesses,” Schwartz said. “It’s by far the best report you have to work with.”
Nevada law requires a report to be filled out by the employer in the wake of an industrial injury. The “C-3” form is mandated by law, and asks employers when, where and how the accident happened. Such information can be crucial is determining whether or not a claim is legitimate.
Schwartz said that when an injured worker changes his story, it should be considered a red flag. He said it’s almost a matter of common sense.
“If you go to work and get hurt, you remember it,” Schwartz said. “If you have a broken arm, you know how you got it. When someone starts changing their story, or doesn’t remember how the accident took place or what he was doing at the time, that’s suspicious.”
Jack Schreiner, claims manager for Nevada Contractors Insurance, said that his company is committed to investigating suspicious claims. “I think we actively investigate more potentially fraudulent claims than any other insurance company in Nevada,” Schreiner said. “In fact, we’re so aggressive when it comes to claims, I think we investigate more claims than all other insurance companies in Nevada combined.”