Most employers and their insurers at one time or another have been adversely affected by the submission of false or fraudulent claims.
Only on rare occasions is the perpetrator caught and successfully prosecuted. Even when the prosecution is successful, more often than not the perpetrator does not have the financial means to return the funds that were fraudulently extracted from the employer and its insurer. In many instances, the employee’s medical provider is complicit in the fraudulent conduct. Indeed, it is not uncommon for the medical provider to incentivize the fraudulent conduct.
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