These employees are actually injured on
the job, but then take advantage of the
system to gain more benefits than they
should. They work to extend their benefits beyond a reasonable period; exaggerate their symptoms; are uncooperative
with treatment plans; and use stalling
techniques when adjusters, medical providers, or employers take positive actions
for the claims management process.
These same tactics are also used by the
abusers described above, but the only
difference is the initial site and intent of
the injury claim. Claims by opportunists
can also become very costly, again deflecting payments from the parties who
Forgotten, frustrated, and
These are employees who were injured on
the job, have legitimate claims, and have
no intent of committing fraud. They fol-
low the rules and cooperate with claims
management activities and efforts by:
proper supervisors or managers.
nurse case manager, or primary physicians to see the medical provider best
qualified to treat them.
• Following all instructions regarding
their medical care and treatment, including the reasonable use of prescriptions.
during their claim, such as medical reports and return to work or continuing
work hardening, functional capacity
evaluations, and/or vocational rehabilitation to re-strengthen themselves
and to increase the probability of their
return to work.
• Informing their medical provider of
their willingness to participate in modified duty if the employer accommodates it, and closely following the medical provider’s orders if it is allowed.
However, if barriers arise that adverse-
ly affect the employee’s treatment or re-
covery, the same cooperative employees
ers move on to other claims, replace
them in the workplace, or move on to
other priorities and responsibilities.
some cases their own employers create
barriers, such as refusing to accommo-
date modified duty.
• Forlorn, the definition of which includes such words as unhappy, sad, and
depressed. We have all seen employees who have become depressed over
a period of time due to their inability
© 2014 Insurance Auto Auctions, Inc. All rights reserved.
IAA is a registered trademark of Insurance Auto Auctions, Inc.
Our analysis. Insight for your industry.
Request our 2013 Industry Report
We Speak Salvage
With more than 30 years of experience, IAA knows the salvage
auction industry. We understand how things like commodity
and currency markets affect your returns, and we share our
insight to help you make smart decisions. At IAA, we recognize
the importance of every type of vehicle.
Untitled- 2 1 5/20/14 11:12AM