Fraud Harms Everyone

Join the Bureau's efforts to help eliminate workers' compensation fraud in Tennessee

Workers' compensation fraud can lead to expensive penalties, inaccurate benefit awards, and unfair advantages to businesses who are not paying appropriate insurance premiums. We take fraud very seriously. Tennessee law and programs within the Bureau are designed to ensure companies are properly insured and all involved parties adhere to state law. 

Fraud occurs when someone "cheats the system" or gives false information in a workers' compensation benefits claim. Fraud could also be committed by employers, insurance agents, insurance adjusters, attorneys, or medical providers - any party involved in a claim.

  • Claiming a work-related injury that is actually not work-related.
  • Exaggerating the extent of the injury.
  • Making a claim for an injury that did not happen.
  • Making employees pay for their own workers' compensation insurance coverage by taking money out of their paycheck.
  • Pressuring employees to not file a claim, even when they are injured at work.
  • Classifying workers' "independent contractors" rather than "employees" to avoid paying workers' compensation premiums.
  • Claiming that employees perform safer jobs that they actually perform. For example, workers are listed as secretaries when they are actually electricians, or painters, etc.
  • Neglected to purchase a workers' compensation policy despite being required by law. 
  • Underreporting payroll or paying employees "under the table" to illegally lower insurance premiums. 
  • Withholding information from insurance carriers to receive deceptively lower workers' compensation premiums.
    • Employers suggesting/requiring injured workers file their claim under their group insurance plan
    • Employers paying for the benefits themselves without notifying its insurance carrier.
  • Insurance adjusters who provide benefits to injured workers that the worker is not supposed to receive.
  • Attorneys who influence physicians to submit medical opinions that would be beneficial to their clients even though the opinions are not based on facts.
  • Nurse Case Managers who do not maintain their independence.
  • Medical providers who send bills to the insurance company for services they did not provide.
  • Insurance agents who sell bogus workers' compensation insurance policies to unwitting employers, accepting payments for the premiums but never notifying an insurance carrier. In other words, no policy is ever actually written.
    • This occurred in Sullivan County, Tennessee where two women were indicted on money laundering, insurance fraud, and theft after being charged with conspiring to create fake workers' compensation policies and pocketing premium payments.
  • Insurance agents who sign employers up fraudulently on the Exemption Registry.

Preventative Measures Taken Against Fraud

  • Our Compliance Program investigates employers to verify businesses obtain the required coverage to comply with workers' compensation law requirements. In addition to coverage, investigators look into how the employer has classified workers. Penalties are assessed against non-compliant entities.
  • Our Penalty Program investigates reports of insurance adjusters, medical providers and others that don't comply with the requirements of the workers' compensation law and rules. This program also assesses and collects penalties, as appropriate.
  • Our Ombudsman Program answers questions about Tennessee's workers' compensation system via phone at 800-332-2667 or by email at wc.info@tn.gov.

Help Eliminate Fraud

  • If you are a business owner operating in Tennessee, carry workers' compensation insurance if the law requires you to do so. Know what to do in case one of your employee's reports an injury.
  • If you are injured at work, know your rights and responsibilities. Employees have rights to certain benefits as outlined in the Tennessee Workers' Compensation Act.

Need More Help?

If you have additional questions, please call 615-532-4812 or 800-332-2667 or contact us by email at wc.info@tn,gov