If you think workers' comp fraud only happens in big corporations, think again.
Small and mid-sized businesses are just as vulnerable... sometimes more so.
Here’s why: 🚩 They often don’t have the same risk controls in place. 🚩 Many don’t challenge claims because they assume it’s "just part of the system." 🚩 They don’t realize how much a single fraudulent claim can impact premiums.
The good news? A proactive approach makes all the difference. We help businesses tighten their risk management, detect red flags early, and build claims strategies that actually work.
If you’re just accepting your workers’ comp costs as a given, it’s time for a new game plan.
From Isaac Muller, CEO of Highview
Workers Comp News & Insights
🔍 WC Market Looks Strong... But Watch Accident-Year Trends
The RPS/Jencap "State of the Workers’ Comp Market" (July 10) reveals stable market conditions and strong profitability, but underneath, accident-year loss ratios are increasing, masked by reserve releases
Broker takeaway: Ask carriers about accident‑year loss trends and reserve levels to ensure true market health.
😲 Ex-California Cop Caught Partying While on WC Leave
A former Westminster, CA police officer collected over $600K in disability benefits for a concussion but was later seen skiing, attending music festivals, running races, and visiting Disneyland. She now faces 15 felony charges and could face up to 22 years in prison.
Brokers, take note:
Fraudulent claims like this can drive up premiums for all insureds.
Encourage clients to use robust fraud monitoring and audit support services.
Understanding the Legal and Financial Implications of Workers' Compensation
In today’s dynamic work environment, it’s crucial for both employers and employees to understand the legal and financial ramifications of workers’ compensation. This newsletter provides a clearer perspective on how workers' compensation impacts an organization’s bottom line and the legal obligations that both employers and employees must navigate.
For Employers
Legal Requirement: Most states require workers’ comp coverage. Noncompliance can lead to fines, lawsuits, or civil liability.
Know Your State: Laws vary. Understand local rules on claims, benefits, and procedures.
No Retaliation: It's illegal to fire or punish employees for filing a claim.
Third-Party Risks: If another party is involved in the injury, employers may face additional legal exposure.
Insurance Costs: Premiums depend on industry risk, claims history, and safety programs.
Claims & Litigation: Disputed or long-term claims can raise costs significantly.
Rehab & Wages: Injured workers may require wage replacement, medical care, and job accommodations.
Productivity Loss: Injuries may disrupt operations and require temporary staffing.
For Employees
Medical & Wage Benefits: Workers’ comp covers treatment and partial wage loss, though not always fully.
Know Your Rights: Timely injury reporting is key to receiving benefits.
Third-Party Lawsuits: Injured workers may also sue third parties for additional compensation if applicable.
Conclusion: Preparing for Workers’ Compensation Challenges
Understanding the legal and financial implications of workers' compensation is essential for maintaining compliance and managing potential risks. Employers should stay informed of evolving laws and best practices to mitigate costs and ensure employees receive the necessary support following an injury. Likewise, employees should be aware of their rights to ensure they receive proper compensation.
We want to keep you informed about the type of accounts we're securing to aid you in understanding the Highview portfolio. We also hope this may inspire ideas for future opportunities to work together.
