Insurance-industry researchers have shown an increase on Mondays of lost-time sprain and strains said to be work-related, but thought to be fraudulent claims for off-the-job weekend injuries.
We examined this issue among civilian employees of the Department of the Navy, using data from claims for injuries occurring between 1989 and 1994.
We found that the rate of Monday sprains and strains significantly exceeded the expected rate and that such claims were significantly more likely to be made by claimants who were craftsmen and mechanics, who reported an injury to the back or trunk, who were supervisors, or who did not have college degrees.
We estimate that 22% of claims for Monday-occurring sprains and strains are possibly fraudulent and that their cost to the Department of the Navy during the 6 years studied was $38 million.
For the entire federal government, costs for such claims during this period may have exceeded $250 million.
Mots-clés Pascal : Compagnie assurance, Dommage corporel, Indemnité dédommagement, Fréquence, Entorse, Variation d'un jour à l'autre, Médecine travail, Homme, Travailleur, Enquête, Milieu professionnel, Système ostéoarticulaire pathologie, Traumatisme, Fraude, Lundi, Week end
Mots-clés Pascal anglais : Insurance company, Physical injury, Indemnity, Frequency, Sprain, Day to day variation, Occupational medicine, Human, Worker, Inquiry, Occupational environment, Diseases of the osteoarticular system, Trauma
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0367955
Code Inist : 002B30B04. Création : 10/04/1997.