It makes sense that Property Casualty 360 (a national underwriter) would publish an article about pro athletes trying to "game the system." The article ends with a link to America's Claims Event, which takes place in Austin this summer. At the Event, attendees can learn how insurers spot fraudulent claims. The article was written by the executive director of the Coalition Against Insurance Fraud, which characterizes fraud as "the crime you pay for."
Indeed, fraud is a real thing, and the insurance industry has a legitimate interest in preventing it.
But the overwhelming majority of people - NFL pro or armchair quarterback - do not perpetrate insurance fraud or make false claims. As the author himself acknowledges, "They are the tiny minority of pro athletes, and sometimes coaches. Yet their high profile makes their fraud crimes large public spectacles in the news media."
The case of the 'inflated' workers' comp claim
As Dennis Jay writes, former NY Giants linebacker Marcus Buckley got prison time for his "inflated" workers' comp claim. Jay describes Buckley's cumulative stress injuries from football playing, which included "memory loss," for which Buckley settled his original claim for $300K in 2010.
But Buckley then "dipped back into the well," as Jay writes, with fake receipts and bills in an attempt to show an additional $1.6M worth of medical treatment that Buckley apparently did not receive.
Buckley got two years in prison. The adjuster who helped him got two years and nine months.
On a side note, you have to wonder whether Jay's description of Buckley's injuries as "memory loss" is a stand-in for CTE, or chronic traumatic encephalopathy - a serious degenerative brain disease that afflicts many NFL players who suffered repetitive head trauma, as Buckley did in his position as linebacker.
If so, it's questionable whether $300K would be enough to cover the cost of dealing with CTE. Of course, this doesn't excuse Buckley's actions, but it might provide a clue as to Buckley's motivation, if there are in fact deeper health concerns at play here.
Call Cousins, Desrosiers & Morizio, P.C.
Be that as it may, Buckley is the exception, not the rule. Most people hurt and in need of workers' comp need compensation to get back on their feet and back to their lives. Many more people are hurt on the job and need to file a legitimate claim than there are those who try to "game the system."
To discuss your case with us, call 866-225-9496.