Fraud Detection & Prevention

Detecting and Preventing Fraud

United Heartland is committed to preventing and detecting fraud through our experienced claims team and Investigative Services Unit (ISU). Our ISU is staffed with former law enforcement professionals experienced in investigating potential workers’ compensation fraud and claims examiners certified by the National Insurance Crime Bureau.

While very few claims are fraudulent, there are several important steps you should always follow to minimize fraudulent claims. This includes:

  • Verification of references and work history upon hire.
  • Immediate reporting of all claims.
  • Reporting of suspicious activity or claims concerns to our anonymous tip line: 800-944-FRAUD (3728).
  • Prominent display of the United Heartland fraud poster in your workplace.

Examples of Workers’ Comp Fraud

  • Falsely reporting payroll figures to reduce premium.
  • A claim made for an injury sustained someplace other than at work.
  • An employee collecting wage payments while working at another job.
  • Physicians billing for services not rendered.

Fraud Warning Signs

  • Claims reported first thing in the morning, especially on Mondays or just after lunch.
  • Claims in which the details surrounding the incident change over time.
  • A medical bill that reflects services not rendered.
  • An injury sustained in a highly populated work area, but without any witnesses.

How to Report Fraud

If you or an employee suspect workers’ compensation fraud, call our anonymous hotline at 800-944-3728. All calls are strictly confidential.


For more information about our Investigative Services Unit, please watch the videos below.

 

ISU Approach & Methodology

 

ISU Fraud

 

ISU Causation & Analysis

 

ISU Philosophy & Overview