How Can There Be a Gap in Coverage?

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…if coverage does not exist in the first place!

We have argued appropriately that coverage cannot exist based on a lack of insurable interest of the non co-employed employee. Not co-employment, not who was or was not payrolled, someone in the system knowingly committed fraud or else coverage would exist. This is not a “gap”, it is “black and white” in terms of coverage being purchased/provided or not.  The beauty of the workers’ compensation system is “The Great Tradeoff” – if you as the employer buy workers’ compensation (wc), you are protected from suit. Said simply, pay the wc insurance premiums and the employee base will be taken care of to the letter of the law.  In all States and DC (except TX, OK and NJ have opt out provisions), workers’ compensation is a mandatory purchase at certain employee counts (4 + typically).  There is no excuse to be ignorant of the need for workers’ compensation nor to pay the premiums necessary to ensure the proper medical and lost time payments due to an injured worker.  In all States, penalties and misdemeanors/ felonies follow with the lack of purchase of wc. 

In NO state is an industry group targeted as a proposed safety net to those that have failed to purchase insurance and committed fraud.  Instead, the fraudsters have a safety net to take the heat off them for not purchasing wc and doing the right thing in the first place. Since all states manage workers’ compensation differently with their own unique rules and rate sets, it falls upon each State to manage the occupational accident and illness exposure of its citizens.

Every state has some form of “subsequent” or “second injury” fund to make sure the cost of employers to hire prior workers’ comp claimants is offset and affordable.  This form of labor umbrella allows for employees to find gainful employment without putting their employers at increased financial risk based on prior events/claims.

Thirty-nine states/district out of 51 have what is generally known as an “Uninsured Employer Fund” (UEF).  In these states, it is all about making sure the injured worker(s) get treatment and benefits first, with the responsibility of the lack of insurance investigated at the same time with the appropriate parties.  The employer(s) whom were responsible for not buying insurance are held accountable, and most importantly, the claimant gets the benefits they deserve without delay and hopefully litigation.

The following 12 States do not have a UEF in order of population:

  • Texas (opt outs allowed)
  • Florida
  • Georgia
  • North Carolina
  • Indiana
  • Alabama
  • Louisiana
  • Iowa
  • Mississippi
  • Arkansas
  • Nebraska
  • Vermont

In these states, for the innocent claimants that have unscrupulous employers that do not wish to purchase workers’ compensation, there is little recourse outside of litigation.  

Not buying wc is fraud. Go after the perpetrators of the frauds and allow for a safety net for those that should matter the most – those the system is built to serve – the claimants.  An uninsured employer fund makes certain the Florida worker is covered, with the bill to be determined post-investigation.

It should be noted that either the Department of Labor or Department of Insurance of most UEF states are the governing authority and therefore something new would not need to be created.  A few states DCBS’ also handle.

Regions Bank Treasury Management sends out information on Emerging COVID-19 Scams

Be aware of Emerging Covid-19 Scams
Author credit: Jeffrey Taylor of Regions Treasury Management Products and Services

Several government agencies have issued a bulletin warning of a new type of COVID-19 scam. Along with the previously reported scams involving personal protective equipment (PPE), COVID-19 testing, and economic stimulus payments, fraudsters are now leveraging the availability of the COVID-19 vaccine. According to the bulletin, victims are being coerced to make an out-of-pocket payment for the vaccine and provide personally identifiable information with a false promise to move their name up on the list of vaccine recipients.

The FBI warns of the following potential indicators of fraudulent activity:

  • Advertisements or offers for early access to the vaccine upon payment of a deposit or fee
  • Requests asking for out-of-pocket payment to obtain the vaccine or be added to the COVID-19 vaccine waiting list
  • Offers to provide additional medical testing or procedures when obtaining the vaccine
  • Marketers offering to sell and/or ship doses of a vaccine, domestically or internationally, in exchange for payment of a deposit or fee
  • Unsolicited emails, telephone calls, or personal contact from someone claiming to be from a medical office, insurance company or COVID-19 vaccine center requesting personal and/or medical information to determine eligibility to participate in clinical vaccine trials or obtain the vaccine
  • Claims of FDA approval for a vaccine that cannot be verified
  • Advertisements for vaccines through social media platforms, email, telephone calls, websites or unsolicited/unknown sources
  • Unsolicited emails, telephone calls, or personal contact from someone claiming to be a government official requiring you to receive a COVID-19 vaccine


Tips to avoid COVID-19 vaccine-related fraud:

  • Consult your state’s health department website for up-to-date information about authorized vaccine distribution channels
  • Check the FDA’s website (fda.gov) for current information about vaccine emergency use authorizations
  • Consult your primary care physician before undergoing any vaccination
  • Don’t share your personal or health information with anyone other than known and trusted medical professionals
  • Check your medical bills and insurance explanation of benefits (EOBs) for any suspicious claims and promptly report such information to your health insurance provider
  • Follow guidance from the CDC and other trusted medical professionals


General techniques for online/cyber fraud prevention:

  • Verify the spelling of web addresses, websites, and email addresses that look trustworthy but may be imitations of legitimate websites
  • Ensure operating systems and applications are updated to the most current versions
  • Update anti-malware and anti-virus software and conduct regular network scans
  • Do not enable macros on documents downloaded from an email unless necessary and only after ensuring the file is not malicious
  • Do not communicate with or open emails, attachments, or links from unknown individuals
  • Never provide personal information of any sort via email. Be aware that many emails requesting your personal information may appear to be legitimate
  • Use strong two-factor authentication, using biometrics, hardware tokens, or authentication apps
  • Disable or remove unnecessary software applications

If you believe you are a victim of a COVID-19 scam, please call Regions Client Services immediately at 1-800-787-3905, and report it to the FBI at www.ic3.gov; wwwtips.fbi.gov; or 1-800-CALL-FBI.

Want more information, or have questions?
For more helpful practices regarding fraud prevention, please visit regions.com/stopfraud and www.regions.com/fraud-prevention.

Scams and Fraud Alerts issued by SBA

The SBA has published information relating to scams and fraud identified surrounding the CARES Act. Read through the article below for tips and links to better protect yourself and your business.

____________________________________________________________________________

SBA Programs – Scams and Fraud Alerts

Effective Jul 14, 2020

By Office of Inspector General


DOWNLOAD .PDFhttps://www.sba.gov/sites/default/files/2020-06/SA2001-1.pdf

Beware of Scams and Fraud Schemes

The Office of Inspector General recognizes that we are facing unprecedented times and is alerting the public about potential fraud schemes related to economic stimulus programs offered by the U.S. Small Business Administration in response to the Novel Coronavirus Pandemic (COVID-19).  The Coronavirus Aid, Relief, and Economic Security Act (CARES Act), the largest financial assistance bill to date, includes provisions to help small businesses. Fraudsters have already begun targeting small business owners during these economically difficult times.  Be on the lookout for grant fraud, loan fraud, and phishing.

Scams and Fraud Schemes

Grants

  • SBA does not initiate contact on either 7a or Disaster loans or grants.  If you are proactively contacted by someone claiming to be from the SBA, suspect fraud.

Loans

  • If you are contacted by someone promising to get approval of an SBA loan, but requires any payment up front or offers a high interest bridge loan in the interim, suspect fraud.
  • SBA limits the fees a broker can charge a borrower to 3% for loans $50,000 or less and 2% for loans $50,000 to $1,000,000 with an additional ÂĽ% on amounts over $1,000,000.  Any attempt to charge more than these fees is inappropriate.
  • If you have a question about getting a SBA disaster loan, call 800-659-2955 or send an email to disastercustomerservice@sba.gov.
  • If you have questions about other SBA lending products, call SBA’s Answer Desk at 800-827-5722 or send an email to answerdesk@sba.gov.

Phishing

  • If you are in the process of applying for an SBA loan and receive email correspondence asking for PII, ensure that the referenced application number is consistent with the actual application number.
  • Look out for phishing attacks/scams utilizing the SBA logo.  These may be attempts to obtain your personally identifiable information (PII),to obtain personal banking access, or to install ransomware/malware on your computer.
  • Any email communication from SBA will come from accounts ending with sba.gov.
  • The presence of an SBA logo on a webpage does not guaranty the information is accurate or endorsed by SBA.  Please cross-reference any information you receive with information available at www.sba.gov.

Report Fraud

Report any suspected fraud to OIG’s Hotline at 800-767-0385 or online at, https://www.sba.gov/about-sba/oversight-advocacy/office-inspector-general/office-inspector-general-hotline.