Fighting Fraud

How to Report Fraud

If you suspect that workers’ compensation or disability benefits fraud is happening, you can report it confidentially and anonymously by calling 1-877-WCNYSIF (926-9743) or using the button below.

REPORT FRAUD NOW

Fraud Awareness Campaign

Insurance Fraud Costs Everyone

Insurance fraud costs New York consumers millions of dollars every year in the form of increased premiums and higher prices for goods and services. According to the Coalition Against Insurance Fraud, insurance fraud costs Americans $308.6 million a year.

A study from the Coalition on Insurance Fraud shows that only 65% of individuals between the ages of 18 and 24 consider insurance fraud to be a crime. More than 27% of 18-24 year olds would submit a workers' compensation claim for an off-the-job recreation injury. Visit the Coalition's website for more statistics surrounding insurance fraud.

Workers’ comp claims can typically involve three parties: the injured worker or claimant, the policyholder or employer, and healthcare providers. Each of these parties can commit fraud, sometimes in collaboration with one another. Here’s a breakdown on key types of workers’ comp fraud:

Employer Fraud Claims Fraud Healthcare Fraud

Perpetrator: Employers/Policyholders

Fraud Committed: Misrepresenting facts – through lying or omission – about a business, revenue, employees, or individual workers’ comp claims.

Motive: To pay lower workers’ comp premiums or to discourage or deny claims from legitimately injured employees. 

Perpetrator: Employees

Fraud Committed: Faking or exaggerating an on-the-job injury or illness.

Motive: To obtain workers’ comp benefits to which the employee is not otherwise entitled. 

Perpetrator: Healthcare providers

Fraud Committed: Misrepresentation concerning medical treatment for a workers’ comp claimant via bill or invoice.

Motive: To be paid for medical treatment that was never conducted, or in some cases, never even needed.
 Employer Fraud Tip Sheet  Claims Fraud Tip Sheet  Healthcare Fraud Tip Sheet

For Criminal Prosecutors

NYSIF’s Division of Confidential Investigations is responsible for all responses to subpoenas (typically grand jury or trial) served on NYSIF from criminal prosecutors' offices.

Subpoenas should be addressed to the following physical address and served via email to DCI@nysif.com:

NYSIF
Division of Confidential Investigations
PO Box 66699
Albany, NY 12206



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