Provider Fraud Is a Multi-Billion Dollar Industry

In this episode of The Comp Effect podcast, host Todd Thams interviews Sam King, Vice President of the Fraud Investigations Department at EMPLOYERS. Sam is no stranger to working in comp fraud. His entire career has been focused on identifying and preventing all types of work comp fraud. Learn what the MILK acronym means, how fraud occurs, and what to look for.

Episode Highlights:

  • Sam shares his background. (1:59)
  • Sam explains why California is not a very conservative state when it comes to workers comp benefits. (10:41)
  • Sam shares one of the schemes they’ve dealt with for years. (19:18)
  • Sam mentions the three types of fraud in workers comp. (22:36)
  • Sam explains what the MILK term is all about. (31:02)
  • How does Sam’s company work to help reduce provider fraud? (39:57)
  • Sam shares one of the biggest fraud cases he’s uncovered. (52:31)
  • Sam mentions he’s currently reading the book entitled, Steel My Soldiers’ Hearts by Col. David H. Hackworth. (1:02:04)
  • Sam mentions that he’s been spending more money on food. (1:03:24)
  • Sam gives a piece of advice to the listeners. (1:04:06)

Key Quotes:

  • “I think one of the things you can do as an employer is making sure you have good people that are good managers, and they’re treating people right. And so, you don’t have those retaliation issues.” – Sam King
  • “So, if you got MILK, if you can prove all four elements of MILK, you can prove fraud. And, I’m talking about criminal fraud for insurance.” – Sam King
  • “If you’re a supervisor or manager, think about that. Be a good manager and treat your employees well. Do the right thing. Don’t be the jerk that people talk about.” – Sam King

Resources Mentioned:

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