What are the penalties under the new law for workers′ compensation fraud?

The penalties for certain types of fraud are a class D felony. For example, any person who knowingly presents a false or fraudulent claim for the payment of benefits on a workers′ compensation claim, or any insurance company or self-insured employer refusing to comply with known and legally indisputable compensation obligations with intent to defraud. The following fraud cases are still regarded as a class A misdemeanor. These include, but are not limited to, to knowingly present multiple claims for the same occurrence with intent to defraud, to knowingly assist or conspire with any person who knowingly presents a false or fraudulent claim for the payment of benefits, to knowingly submit a claim for a health care benefit that was not used by or on behalf of the claimant, to knowingly make false or fraudulent statements with regard to entitlement to benefits with the intent to discourage an injured worker from making a legitimate claim. If a person has previously been found to be guilty or pled guilty to workers′ compensation fraud, and subsequently commits fraud, that person shall be guilty of a class C felony. If a person prepares or provides an invalid certificate of insurance as proof of workers′ compensation coverage the person is guilty of a class D felony and is liable to the state of Missouri for a fine up to ten thousand dollars or double the value of fraud, whichever is greater.

Workers' Compensation - Insurance

  1. What is workers′ compensation insurance?
  2. Does an employer have to carry workers′ compensation insurance?
  3. What are the penalties under the new law for workers′ compensation fraud?
  4. How do I obtain coverage?
  5. How is workers′ compensation insurance priced?
  6. What is the period of Limitations to file a claim for compensation with the Division?
  7. When do insurers and third-party administrators have to report an injury to the Division?
  8. If I am a self-insurer, do I need a third-party administrator?
  9. Do I need to notify the Division of changes to my self-insurance program?
  10. I am an employer with multiple subsidiaries. Would my subsidiaries be covered under the same self-insurance authority as the parent company?
  11. How long does it take for an application to be processed? My policy expires soon and I want to be self-insured by the time it is renewed.
  12. The parent company and several subsidiaries are already self-insured. Do I need to resubmit the same data, such as the Third Party Administrator agreement, that applies to all the other entities? Will the application still take that long?
  13. What are the on-site safety audits?
  14. How much security is required to be posted? How is this amount calculated?
  15. Due to a corporate restructure, our current self-insured entity was merged out of existence, and a new entity was created. Will the new entity need to apply for self-insurance? Since the new entity has the same employees, can we transfer the security from the old self-insured entity to the new one? My broker does not have any problems with this.
  16. How do I get my security reduced?
  17. How do I get my security released?
  18. What forms of security are acceptable? What are the requirements for each?
  19. I keep getting a notice that my Excess Insurance Certificate is unacceptable. What is the Division looking for on the certificate?
  20. Our broker informed me that we can save money by increasing our self-insured retention. What is required for a retention increase?
  21. Our company has changed names/was bought out by another company? What do we need to submit to the Division?
  22. Does an individual self-insured employer incur any surcharges or taxes?
  23. What should I do if I wish to terminate my self-insurance authority?
  24. What is the excess insurance policy limit requirement?
  25. Are self-insured employers and groups allowed to handle their claims differently or pay different benefits than insurance carriers?
  26. My employer is self-insured. My weekly check is always late. What can I do?
  27. Is there a Guarantee Fund for groups?
  28. Who sets the premium amount for my group?
  29. What if my employer is no longer in business?
  30. What if my employer is no longer a member of the group?
  31. What if the group that my employer belonged to is no longer in business?

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