Workers' Compensation Fraud & Noncompliance

Because everyone, both employees and employers, benefit from workers' compensation insurance compliance, it's important to let us know when businesses may be in violation of Workers' Compensation laws. Please take the time to review who is required to have Workers' Compensation Insurance and read the descriptions of different types of fraud and noncompliance below. If you would like to report a possible violation or complaint, or have any questions, please contact us right away.

When is Workers' Compensation Insurance Required?

Missouri Employers are required to carry workers’ compensation insurance if they have five or more employees.  Missouri Employers involved in the construction industry are required to carry the coverage if they have one or more employees.  This applies to all employers, regardless of whether the employees are part-time/casual laborers, full-time, or family members.

Members of an LLC and officers of a corporation apply towards this employee count, sole proprietors and members of a partnership do not.

• More information about liability requirements and exceptions

Types of Workers’ Compensation Fraud and Noncompliance

Employee Fraud

Knowingly making a claim for workers’ compensation benefits to which an employee knows he/she is not entitled or knowingly presenting multiple claims for the same occurrence is a class E felony, punishable by a fine of up to $10,000 or double the value of the fraud, whichever is greater. A subsequent violation is a class D felony.

Employer Fraud

Knowingly misrepresenting an employee’s job classification to obtain insurance at less than the proper rate is a class A misdemeanor. A subsequent violation is a class E felony. An employer who knowingly makes a false or fraudulent statement regarding an employee’s entitlement to benefits to discourage the worker from making a legitimate claim or who knowingly makes a false or fraudulent material statement or material representation to deny benefits to a worker is guilty of a class A misdemeanor punishable by a fine of up to $10,000. A subsequent violation is a class D felony.

Insurer Fraud

Knowingly and intentionally refusing to comply with known and legally indisputable workers’ compensation obligations to which an insurance company or self-insurer knows an employee is entitled is a class E felony, punishable by a fine of up to $10,000 or double the value of the fraud, whichever is greater. A subsequent violation is a class D felony.

Employer Noncompliance

Knowingly failing to insure workers’ compensation liability under the law is a class A misdemeanor punishable by a fine of up to three times the annual premium the employer would have paid had it been insured or up to $50,000 whichever is greater. A subsequent violation is a class E felony. An employer who willfully fails to post the notice of workers’ compensation at the workplace is guilty of a class A misdemeanor punishable by a fine of $50 to $1,000 or by imprisonment or both fine and imprisonment.

Complaint Process

Any person may file a complaint alleging fraud and noncompliance with the Fraud and Noncompliance Unit (FNU). All investigations conducted by the FNU are criminal in nature and must be kept confidential. Due to the confidentiality of FNU investigations, persons lodging complaints are not provided information on the outcome of the investigation prior to prosecution. If the investigation reveals a violation of the statute, the FNU presents the findings of fraud and noncompliance to the director of the Division of Workers’ Compensation. The director may refer the case to the Missouri Attorney General for prosecution.

Any fines or penalties levied and received as a result of prosecution under this law shall be paid to the Workers’ Compensation Fund. The FNU does not settle claims or pay benefits. If you believe you have accurate information with regard to someone not complying with workers’ compensation laws, or know someone who may have committed fraud, please report it.Accordion content.