Worker Files Multiple Fraudulent Workers’ Compensation Claims

August 13, 2015

Employers in California are required to provide workers’ compensation insurance coverage for their workers. Instead of accepting coverage as a benefit, some workers choose to misrepresent their injuries and file fraudulent workers’ compensation claims. Tactics may include false declarations of the manner in which injuries occurred or exaggerations about the severity of the workplace injuries.

A worker in another state was recently convicted of charges of workers’ compensation fraud, following an investigation by the Illinois Department of Insurance Workers’ Compensation Fraud Unit. According to court documents, the filed reports of injuries the woman claimed to have suffered at several workplaces were fraudulent. Investigators determined that her medical condition was misrepresented, and her descriptions of her symptoms provided to her employers, doctors, and insurance companies were exaggerated. It was stated that her actions were an attempt to be awarded benefits for temporary total disability.

It was also established that 19 claims for workers’ compensation benefits had been filed by this worker against several employers since 1987. This investigation involved three of the companies that were defrauded by this worker. She pleaded guilty to felony charges of workers’ compensation fraud, and her sentence included probation for two years, and a restitution payment of $14,737.86, along with fines, costs, and fees.

California employers who want to protect their businesses against fraudulent workers’ compensation claims may recognize the importance of being educated on tactics workers may use to fraudulently obtain benefits that will ultimately affect the insurance premiums they, as employers, have to pay. Retaining the services of an experienced employee fraud attorney may be beneficial. Such a professional can educate employers on how to recognize fraudulent claims and assist with actions to hold employees responsible for such illegal acts.

Source: workerscompensation.com, “Illinois Claimant Convicted of Workers’ Compensation Fraud”, 16, Aug. 11, 2015

Recent Blogs

Red Flags for Identifying Fraudulent Workers’ Compensation Claims

Workers’ compensation claims are designed to support employees injured on the job. However, fraudulent claims can undermine this system, driving up costs for businesses and hurting employees with legitimate needs.…

Legal Strategies for Uninsured Employers Facing Workers’ Compensation Claims

Facing a workers’ compensation claim as an uninsured employer can be overwhelming. California has strict laws requiring employers to carry workers’ compensation insurance, and failing to comply can lead to…

Legal Requirements for Employer Subrogation in California

Workers’ compensation insurance typically covers the costs when an employee is injured on the job. However, when a third party is responsible for the injury, employers in California have the…

    Contact Us