Report it

If you suspect a worker, employer, or medical provider of committing workers’ compensation fraud, there are many ways to report it.

REPORT FRAUD NOW
FRAUD

An intentional deception for the purpose of financial gain.

or individual

LWCC covers only Louisiana businesses and organizations

workplace safety

Guaranteeing your workplace is as safe as possible for your workforce is the best way to minimize risk and decrease chances of workplace injury.

system of free resources

A vast online library of regularly-updated safety resources, tools, and references made available to policyholder for free.

safety experts

LWCC’s Consultants on Call are dedicated to understand your operations and customizing safety solutions to meet your needs.

mutual insurance company

We are mandated to serve the mutual benefits of its members.

personalized service

Our Agency Relations representatives are available to partner with you to serve your policyholders through in person or virtual visits, depending on your preference.

underwriting team

Specialized team with in-depth knowledge of the unique needs of companies of various sizes and specialties.

tools and information

The team assists agents in connecting to relevant department contacts, as well as resources, tools, guides, and educational materials available from LWCC.

dedicated agent resource

LWCC Agency Relations are here to serve agents and their staff only.

compassionate care

Genuine compassion requires the experience to know what matters and what help is actually needed.

plan development

WorkAction plans are customized to the injured workers’ needs by vocational rehabilitation specialists.

early intervention

Our WorkAction return-to-work program capitalizes on the window of opportunity right after an employee is injured to help create a return-to-work plan that works for you.

return-to-work program

Our experienced team helps design the right program for individual claims, or assist you in creating a proactive program to safely get your employee back to work — all at no cost.

quality medical care

Including hospitals, clinics, specialists, pharmacies, physical therapists, chiropractors, diagnostic testing, durable medical equipment vendors, rehabilitation, and home healthcare providers.

skilled providers

LWCC has selected providers across the state based on their expertise in occupational medicine, professional credentials, use of established treatment guidelines, and effective return-to-work practices.

prompt access

With OMNET®, injured employees are guaranteed appointments with specialists on a priority basis.

statewide

The first of its kind in Louisiana, OMNET includes providers across the state, even in rural areas.

strong financial results

Dividends are made possible through the sound counsel of agent partners, employees’ dedication to excellence in execution, and policyholders’ continued commitment to safety and wellness.

policyholders

Returns are maximized by long-term policyholders who become fully vested in the dividend program.

shared

A unique benefit for policyholders of a mutual insurance company.

workers’ compensation related

Provide a broad range of litigation services in the workers’ compensation arena.

provides counsel

The team handles cases of all sizes, regardless of the complexity of the dispute at issue.

in-house legal team

The Johnson, Rahman & Thomas team has approximately 19 lawyers, paralegals and legal assistants.

correct premium

Per the policy, the final premium is determined after the policy ends by using the actual premium (validated at the audit), along with proper classifications and rates.

charged

May help identify gaps in coverage or discounts or credits that may apply to your policy.

opportunity

The audit is an important step in the workers’ comp insurance process.

financial gain

Can include paid benefits, unnecessary treatment or prescriptions, misrepresenting business details, and more.

intentional deception

Deception by a member of the workforce, a company leader, or a healthcare provider.

fully protect

Workers’ compensation is a form of insurance providing wage replacement and medical benefits to employees injured on the job.

assist employers

Agents solicit and negotiate insurance contracts for the best fit between an insurer and a business or organization.

valuable resource

LWCC does not write workers’ comp policies directly with employers. We are proud to partner with agents across the state to provide outstanding service to our policyholders and their workers.

business, organization,

LWCC covers only Louisiana businesses and organizations

insurance policy

Our focus always has and always will be workers’ comp insurance

business or individual

LWCC covers only Louisiana businesses and organizations

injured workers

LWCC understands the difficulty of being injured on the job and is there to help those requiring assistance in recovery and return to work.

workers’ compensation

A form of insurance providing wage replacement and medical benefits to employees injured on the job.

private, nonprofit

We are mandated to serve the mutual benefits of its members.

evaluate corporate performance

The broader impact a company is having on the community and the world.

Non financial factors

Environmental, social, and governance

safety resources

Training, information, and experienced professionals made available to policyholders to prevent workplace accidents and improve overall workplace safety.

Types of Workers' Comp Fraud

Workers’ comp fraud can happen in numerous ways. No matter what type of fraud, we all pay. Here are just some forms of fraud.

Impact of Workers’ Comp Fraud

Most workers’ compensation claims are perfectly legitimate, however, the FBI estimates that 10 percent of all claims contain some element of fraud. When someone commits fraud, everyone gets ripped off.

It's a rip off

Insurance fraud is the second most costly white-collar crime in America after tax evasion. The Coalition Against Insurance Fraud estimates that the average American household pays over $950 a year in additional premiums to cover the cost of insurance fraud. Insurance fraud is a crime that costs Louisiana citizens alone over $2.3 billion a year through higher taxes, increased insurance premiums, and higher costs of goods and services.*

*Louisiana State Police, Bureau of Investigation, Fraud Unit

It's wrong

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It's a racket

Insurance fraud is the second most costly white-collar crime in America after tax evasion. The Coalition Against Insurance Fraud estimates that the average American household pays over $950 a year in additional premiums to cover the cost of insurance fraud. Insurance fraud is a crime that costs Louisiana citizens alone over $2.3 billion a year through higher taxes, increased insurance premiums, and higher costs of goods and services.*

*Louisiana State Police, Bureau of Investigation, Fraud Unit

Fraud Reporting Rewards Program

LWCC’s Fraud Rewards Program rewards anyone meeting the eligibility requirements who provides information on suspected workers’ compensation fraud against LWCC that leads to an arrest. The eligibility requirements are as follows:

A reward of $1,500 will be given to an informer who supplies information leading to the arrest of anyone defrauding LWCC. The reward will be presented only after an arrest is made.

Tipsters must give their name and address. This information will not be released without written permission or a court order. Of course, outside of the reward program, anonymous tips are always accepted.

LWCC must be the insurance company involved.

Decisions to investigate tips will be made based upon the quality of information received.

If the case is already under investigation, the tip must supply new substantive information that furthers the successful completion of the investigation.

LWCC policyholders (owners, officers and principals), Insurance agents, and LWCC employees, and their families are not eligible for the rewards program.

In the case of multiple reports on the same case, LWCC will present the reward to the first substantive report. LWCC’s decision in this regard is final.

How to Prevent Workers’ Compensation Fraud

Take Action at Your Workplace
  • Investigate all accidents.
  • Implement sound investigation techniques that can help you correct any hazardous conditions contributing to an injury and uncover any signs of possible fraud.
  • Review video surveillance of the accident scene if available.
  • Separate witnesses and interview them as soon as possible following an accident.
Promote a Fraud-Free Workplace
  • Discuss workers’ compensation policies and procedures, including what employees should do if they are hurt on the job.
  • Inform employees that workers’ comp is there to help employees who are injured but fraud is a crime that LWCC will prosecute.
  • To prevent off-the-job accidents from being filed as workers’ comp claims, explain to employees how short-term disability works if you offer that benefit.
Start a Return-to-Work Program

When employers have transitional duty available for employees, committing fraud becomes less tempting.


Use Sound Hiring Practices
  • Conduct criminal background and drivers’ license checks before hiring new employees.
  • Verify references and information listed on job applications.
Conduct Periodic Safety Checks
  • Your safety program should include regular inspections of the work area and equipment.
  • Fix any hazards immediately and document all checks and repairs.

Click here for more information on developing your own written safety plan

Hold Exit Interviews

To discourage post-termination claims, part of your exit interview should include a signed statement from the employee as to whether or not he/she experienced any unreported injury at work.

Learn Potential Fraud Indicators

According to the National Insurance Crime Bureau, a claim might be fraudulent when two or more of these signs are present:

  • Following the accident, rumors spread amongst employees about possible foul play.
  • An unusually long time passes before the claim is reported, especially if the injury is serious.
  • The employee can never be reached at home or on a mobile phone.
  • The employee switches doctors after being released to work.
  • The employee’s story of the accident changes.
  • No one witnessed the injury.
  • The claim is older than three months, and...
  1. the accident occurred on a Friday afternoon or Monday morning;
  2. the accident happened just before a strike, layoff, termination, or the end of seasonal work; or
  3. the accident happened outside of the employee’s normal working hours.

If any of these indicators exist on a claim being handled by LWCC, please notify the Claims Representative so he/she can investigate further.

Fraud Reporting Options

If claims activity related to workers’ compensation fraud is suspicious, the following options are available for reporting.

Call LWCC’s toll-free Fraud Hotline

800-933-FRAUD (800-933-3728)

Call to report suspicious claims activities. Concerns and fraud prevention questions will be answered directly by an LWCC special investigator.

Online Fraud Reporting Form

If you would like to report someone who you think may be committing workers' compensation fraud, complete the information in this form. You may choose to submit this information anonymously; however, this may limit the scope of the investigation. If you need to report fraud on a claim not being handled by LWCC, or a policyholder not insured by LWCC, please report it directly to the Louisiana Workforce Commission.

* This form is for Louisiana only. If you would like to report workers' compensation fraud in a state other than Louisiana, please contact the desired state's workers' compensation office or website.

What type of fraud are you reporting?

Our Fraud Investigation Practices

LWCC’s special investigation unit collaborates with the claims teams to help mitigate exposure to determine which claims warrant further investigation and SIU intervention. Where indicated, LWCC will submit fraudulent files for criminal prosecution.