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SOFA-CFE · Question #389

The primary victim of what is not the employer but the insurance carrier for the employee?

The correct answer is B. Worker's compensation scheme. Option B is correct because in a workers' compensation scheme, when an employee commits fraud (e.g., faking or exaggerating a workplace injury), the claim is filed against the employer's workers' compensation insurance policy. The insurance carrier - not the employer…

Question

The primary victim of what is not the employer but the insurance carrier for the employee?

Options

  • AEmployee's fraud cash filter
  • BWorker's compensation scheme
  • CEmployees' recognized codes of conduct
  • DWorker's profit scheme

How the community answered

(38 responses)
  • A
    11% (4)
  • B
    82% (31)
  • C
    5% (2)
  • D
    3% (1)

Explanation

Option B is correct because in a workers' compensation scheme, when an employee commits fraud (e.g., faking or exaggerating a workplace injury), the claim is filed against the employer's workers' compensation insurance policy. The insurance carrier - not the employer - ultimately pays the fraudulent claim, making the insurer the primary financial victim, even though the fraud was perpetrated against the employer's account.

Why the distractors are wrong:

  • A (Employee's fraud cash filter) is not a recognized legal or insurance concept - it's fabricated terminology designed to sound plausible.
  • C (Employees' recognized codes of conduct) refers to ethical/behavioral guidelines, which have nothing to do with who bears financial loss from fraud.
  • D (Worker's profit scheme) is also invented terminology; no such scheme exists in standard employment or insurance law.

Memory tip: Think of workers' comp as a triangle - Employee → Employer → Insurance Carrier. When an employee commits fraud, the claim travels the whole triangle, and the carrier at the far end absorbs the loss, making them the hidden victim. Ask yourself: "Who actually writes the check?" - that's your primary victim.

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