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Fraud Control

Losses resulting from workers' compensation fraud and abuse affect every business. Workers' compensation fraud may originate with claimants who make false statements in order to qualify for benefits, with medical providers who submit bills for services not rendered or with employers who deliberately falsify payroll information. No matter what the source or origin, Lovell Safety Management is committed to uncovering, eliminating, and prosecuting fraudulent practices.

Studies have shown that between 10% and 25% of all workers' compensation costs involve fraud or abuse, and that less than 20% of abuse cases are identified. This means that every employer is forced to cover the cost of workers' compensation dollars lost by fraud.

At Lovell, our mission is to ensure that our group members get the best coverage at the lowest possible cost. We recognize our responsibility is to aggressively pursue investigations into any suspected cases of fraud or abuse — and the record points to our success.

Below are examples of several controverted cases where Lovell's thorough investigations revealed abuse and resulted in decisions that protected and/or benefited our group members.

Claimant Alleged Shoulder injury sustained while transferring a patient from a geri–chair to a bed.
Findings of Lovell Investigation Injury was the result of a prior incident, any claim for which was prevented by the statute of limitations.
Decision Claim disallowed. Case closed.
Claimant Alleged Pain in right knee stemming from work duties
Findings of Lovell Investigation No prima facie medical evidence, possible link to prior football injury.
Decision Insufficient evidence of occupational injury or disease. Case closed.
Claimant Alleged Development of occupational asthma due to exposure to colophony (pine resin) fumes.
Findings of Lovell Investigation Previous medical history of mold allergies, chronic nasal congestion and sinus symptoms.
Decision Award reduced in part because of prior medical history.

Watch Our Presentation on Workers' Compensation