S & C Claims Services, on behalf of Builders Insurance Company, has reportedly already racked up five convictions this year for workers’ comp fraud. In addition, S & C Claims Services has sent at least one other fraudulent claimant packing, fleeing the state of Nevada to avoid prosecution.
“Aggressive identification and prosecution of fraudulent injury claims is one of the cornerstones of our success in lowering workers’ comp costs for Nevada contractors,” according to Tom Wheeler, vice president of Builders Insurance.
S & C Claim Services is the third-party administrator which handles claims for Builders Insurance Company, one of Nevada’s two largest carriers of workers’ compensation insurance. Explaining their success in helping Builders Insurance hold the line on rising workers’ comp insurance costs, David Oakden, S & C Claims Service’s operation manager, said, “We routinely investigate all suspicious workers’ comp claims – and, in 2005, this has meant that Builders Insurance has seen a record number of convictions for fraud, and at least one other suspected fraudulent claimant has fled for fear of being prosecuted.”
Although the dollars recovered from individuals prosecuted under Nevada’s anti-fraud statutes are often for relatively minor amounts – for instance, one claimant agreed to pay back $500 – Oakden said that when claims are shut down it means substantial savings for the program.
“We stop fraud practitioners from getting a disability rating,” Oakden said. “That’s where the savings are significant. A disability rating, if legitimate, can be worth tens of thousands of dollars to the recipient of that rating.”
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