Fraud — Frequently Asked Questions

Workers’ compensation fraud can take many forms, and some signs may be subtle. Potential indicators include: 

• Inconsistent information about the business, employee duties, or payroll 
• Undisclosed work locations, operations, or employees 
• Frequent changes in classification codes or payroll reporting 
• Prior claims or policy histories that don’t match current details 
• Medical bills or treatment patterns that appear excessive or unusual 

If you notice anything that doesn’t seem right, you can report it through our Fraud Hotline or online fraud referral form.

Anyone can report suspected fraud—including employers, agents, medical providers, and employees.

You may submit a fraud referral through:

• Fraud Hotline: 1‑800‑944‑FRAUD
• Online Fraud Referral Form 

All referrals are reviewed promptly. Information is kept confidential to the extent permitted by law.

Once our Special Investigations Unit receives a referral: 

• The case is reviewed and triaged.
• SIU may collect additional information such as business records, tax documents, prior policies, or publicly available data.
• If needed, SIU may conduct interviews, site visits, background checks, or work with investigative vendors.
• When evidence of fraud is identified, we may report findings to state insurance fraud bureaus, law enforcement, or pursue restitution or civil recovery.

Our goal is to ensure accurate premiums, protect the integrity of the workers’ compensation system, and support fair outcomes for all stakeholders.

Yes. Fraud—such as misclassifying employees, underreporting payroll, or failing to disclose business operations—can result in:

• Incorrect premium calculations
• Significant financial penalties
• Policy cancellation
• Possible legal consequences 

Providing complete and accurate information helps ensure that premiums remain fair and compliant with state regulations.