Temporary Disability Insurance Audits
Employer Audits:
- Minimum wages for maximum weekly benefit amount
- Employer filing as claimant
- Close-to employer address for claims
- Minimum outside high quarter wages
- High percentage of claims
- Fake last employer
Agent Audits:
- Close-to agency employee address
- Agency employee telephone number for claims
- Agency employee filing as a claimant
Claimant Audits:
- Valid Social Security Number
- Multiple claims to one address
- Close-to claimant address
- Birthday pattern
- Repeated (IVR call-in) telephone number
- Same (claimant contact) telephone number
- Repeated IP address
- Last employer not in base period
- Claimant filing continued claims for the same disability
- Claimant address is a P.O. Box
- Multiple claims at the same time of year
Physician Audits:
- Same physician certifying a high percentage of claims