On average, medical expenses constitute about 65% of total workers' compensation benefits*.  Many factors can drive these expenses higher.  Zenith’s SIU targets one of those factors: medical provider fraud and abuse.

Zenith leads the way in exposing fraud and uses every legal avenue to enforce its zero-tolerance policy. And we mean it—Zenith was the first workers’ compensation company to successfully sue a provider under California’s anti-fraud law.

Our investigators root out provider fraud by focusing on unusual patterns in:

• Upcoding and billing over state fee schedules
• Medications dispensed by doctors
• Provider licensing

Learn how to spot red flags of healthcare fraud.

*WCIRB Summary of 12/31/2011 Insurer Experience