Managing HR in Florida means staying ahead of changing regulations, rising employee expectations, and seasonal hiring demands. As the year winds down, businesses in communities like Bradenton must remain vigilant against workers' comp fraud, a costly threat that impacts premiums, audits, and overall profitability.

In this article, we’ll share key strategies small and mid-sized businesses can use to protect their teams and grow sustainably with the help of flexible HR solutions. We'll show you how proactive monitoring and documentation, facilitated by a professional employer organization (PEO) expert, can save time and costs.

FRM at a Glance

Florida Resource Management (FRM) is a family-owned PEO, founded in 2012. We specialize in payroll, benefits, Workers’ Comp, and core HR functions. Headquartered in Sarasota, FL (with offices in Port St. Lucie and Pensacola), we serve 500+ clients and 10,000+ employees across the Southeast (FL, GA, AL, LA, NC, TN, KY). With over 100 years of combined team experience, we deliver flexible, high-touch solutions that enable business growth.

The Two Faces of Workers’ Comp Fraud in Bradenton

Workers' compensation fraud in Florida is a serious offense that can be committed by both employees (Claimant Fraud) and employers (Premium Fraud). Both types drain resources from honest businesses and inflate insurance costs for everyone.

1. Identifying Claimant Fraud Red Flags

Claimant fraud occurs when an employee seeks benefits through pretenses, a major concern for any employer. While most claims are legitimate, vigilance is key. Here are some key red flags for workers' comp fraud that  Bradenton businesses should monitor:

• The Monday Morning Report: The injury is reported first thing Monday morning for an incident that allegedly occurred late Friday, often suggesting a non-work-related weekend injury.
• Unwitnessed Incidents: The accident occurs without witnesses, even when co-workers are typically present.
• Late Reporting: The employee delays reporting the injury without a valid explanation.
• Suspicious Timing: The injury occurs immediately before or after a layoff, termination, strike, or at the conclusion of seasonal work.
• Treatment Avoidance: The employee misses or avoids diagnostic procedures or doctor-ordered physical therapy.
• Unavailable Claimant: The injured employee is hard to reach at home or is documented engaging in activities inconsistent with the claimed injury (e.g., heavy lifting, sports).

2. Protecting Your Business from Premium Fraud

Employer fraud, known as Premium Fraud, is often more financially devastating and usually involves misrepresenting payroll to reduce insurance costs. This is a severe criminal violation in Florida.

• Underreporting Payroll: Intentionally providing erroneous payroll data to the insurance carrier.
• Misclassification: Misclassifying high-risk workers (like roofers) into lower-risk categories (like clerical staff).
• Misclassifying Employees: Treating actual employees as independent contractors to avoid paying workers' comp premiums.

FRM’s Commitment: As a PEO, FRM handles your payroll and employee classification, virtually eliminating the risk of accidental premium fraud, a compliance challenge we manage daily for our 500+ clients.

Reporting Best Practices and Documentation Tips

If you suspect workers' comp fraud, you must act quickly, but also correctly, to protect your business's legal standing.

Documentation: Your Best Defense Against Fraud

Your internal records are the foundation of any investigation. We advise managers and HR personnel to focus on:

• Timeliness: Document the date, time, and exact location of the injury immediately upon notification.
• Witness Statements: Obtain written, signed statements from all witnesses as soon as possible, while memories are fresh.
• Video Evidence: Secure any surveillance video (if available) that shows the area before, during, or after the alleged incident.
• Inconsistency Log: Keep a detailed, factual log of any observed inconsistencies (e.g., the employee's activity on social media, missed appointments, conflicting stories).
• Prompt Reporting to PEO/Carrier: Immediately notify your workers’ comp carrier or FRM. Timely reporting is crucial for controlling the claim and initiating potential investigation.

How to Report Workers' Comp Fraud in Florida

If your suspicions are strong, you can confidentially report fraud directly to the state. The Florida Department of Financial Services (DFS) maintains a dedicated Bureau of Workers’ Compensation Fraud.

Real-World Solution: Proactive Monitoring Saves Time and Costs

As a specialized PEO southwest provider, FRM’s integrated HR model gives your business a powerful advantage against fraud that national providers often miss.

Example Scenario: Bradenton Retailer

A Bradenton retail client reported an employee who sustained an unwitnessed slip-and-fall injury on a Monday morning. The employee immediately hired an attorney and refused light-duty work, claiming total disability.

• FRM’s Proactive Action: Because FRM manages both payroll and workers’ compensation, our claims specialist immediately reviewed the employee's personnel file, flagging a history of frequent job changes (a known red flag). We also noticed the claim was filed just before a planned company-wide reduction in seasonal staff.
• The Result: Our specialist collaborated with the carrier’s Special Investigations Unit (SIU) based on the clear red flags. The investigation, which included surveillance, confirmed the employee was working a second, physically demanding job while collecting lost wage benefits. This proactive monitoring led to the claim being denied, saving the client tens of thousands of dollars in reserve costs and protecting their Experience Modification Rate (E-Mod).

FRM’s Value: With over 100 years of combined industry experience, our service team doesn't just process paperwork; we apply expert knowledge to actively protect your business interests. We deliver flexible, high-touch HR solutions that enable you to stay focused on growth and success.

Protect your business from unnecessary losses. 

FRM helps you detect, prevent, and manage workers’ comp fraud effectively.