CALIFORNIA Beating Workers Comp Fraud Case by Case

New Fraud Prevention Program Results in Conviction

“Work Comp fraud goes beyond the few employees who abuse the system,” said Ron Paine, vice president of Risk Control for CHSI. “Phony providers and double billing are a major problem. Employees can be taken advantage of by unscrupulous attorneys. Our new One Source doctor network and our employee support program are going to help us in beating Work Comp fraud.”

“Fraud hurts everybody,” commented David Mitchell, chair of the California Restaurant Mutual Benefit Corporation (CRMBC Board.) “Employers face a challenging economy and Work Comp fraud makes it that much tougher. It can cost jobs. Our aggressive anti-fraud campaign is one of the reasons that we have been able to cut costs for our employer members.”

Under the new program, (CRMBC) reports another conviction for felony workers’ compensation fraud committed against one of its employer members.

A California man pleaded guilty in Ventura County to one count of work comp fraud after being arrested for collecting benefits illegally and making false statements while an employee of a CRMBC member in Ventura.

The individual reportedly received more than $30,000 in tax-free disability payments while receiving treatment over a 15-month period. During this period he took a job at another restaurant. (workersxzcompxzkit)

At a deposition following his arrest, the man reportedly denied working at any job since the injury. Intercare, the claims management company working for CRMBC, used its fraud investigation unit to develop information for the California Department of Insurance, Fraud Division. The District Attorney for the County of Ventura prosecuted the case.

Author Robert Elliott, executive vice president, Amaxx Risks Solutions, Inc. has worked successfully for 20 years with many industries to reduce Workers’ Compensation costs, including airlines, health care, manufacturing, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. He can be contacted at: [email protected] or 860-786-8286.

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker about workers’ comp issues.