Most often when an employee files a claim about an on the job injury, it’s legitimate. But, then there’s the instance of Bruce Gilbert, an outrageous case which was blown wide open after he collected $774,000 in workers’ compensation benefits over the course ten years. His wife claimed he was injured on-the-job and had suffered a regressive mental illness that left him with the mental capacity of a five-year-old. When an insurance investigator visited them, Bruce told him in a childlike voice that he liked books “about animals.” However, a private investigator discovered the Central Florida man hunting and playing golf, amongst other outdoor activities. Gilbert and his wife were both arrested, and while in the police car, a hidden voice recorder caught Mrs. Gilbert instructing her husband to fake another injury.

In South Florida, security video captured a woman staging an accident. A sprinkler head fell from the ceiling and landed on her desk. The video shows her looking around to see if anyone noticed, and when they didn’t, she took the opportunity to smack herself in the head with it. She filed a workers’ compensation claim, but her employer’s insurance company got suspicious and requested security footage. She was fined and had to return the money she collected.

And, a woman in Ohio might have gotten away with her scam if she had stayed away from social media. She told her employer she slipped and fell in the parking lot. She collected benefits but had to return them (and pay a fine) after The Ohio Bureau of Workers’ Compensation found out about a Facebook post where she said she fell at a nearby gas station.

The Coalition Against Insurance Fraud says most workers are honest. It’s a minimal number that scam the system out of money for personal gain. However, even that small number adds up to tens of thousands of dollars in false claims every year.

How to spot a fake injury:

• If the worker is not happy or is involved in a dispute at work, they may be trying to get some time off work.
• If an incident happened on a Monday, you might be suspicious. It’s possible it happened over the weekend.
• It could be a red flag if there are no witnesses.
• If someone tells you he or she was hurt three months ago, but didn’t report it at the time, it may not be legitimate.
• If the worker has a history of filing workers’ compensation claims, they may be looking for a pay-out.

Normandy Insurance understands an effective workers’ compensation program must include a strong, proactive focus on safety and loss prevention, and ongoing interest in making the workplace safe and accident-free. We strive to service our small business clients by lowering the costs of claims and helping to prevent injuries. If we can help you in any way, please get in touch.

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