Workers’ Compensation Insurance Fraud: Business Situations, Injuries, Medical Claims, and the Illegal
Unfortunately, the insurance industry has always reported incidents of fraud, whether it involves home, business, auto, life, coverage, or even bond insurance. However, no niche is as vulnerable to false claims as workers’ compensation. Read these amazing cases and join the insurance companies’ fight against fraudulent activity.
Steal from the rich to give to the poor
This may sound like it’s straight out of fairy tale books, but it’s true!
An elderly doctor was found guilty of workers’ compensation fraud. His criminal activity consisted of filing dishonest insurance claims totaling more than $170,000. The ‘good’ doctor pleaded for mercy to the judge who sentenced him while explaining the facts of his crime. What made him different from other thieves was that he had deliberately overcharged patients who had their medical bills paid for by workers’ compensation coverage. In this way, he was able to care for patients who could not pay out of pocket. The judge took this into consideration by sentencing him to only 5 years of probation and one year of confinement in his own home.
a sad conclusion
A former employee hurt his arm on the job and continued to collect disability benefits even after he got better and massaged clients for a fee. The US Department of Labor found out about the hoax and charged him with one felony count related to insurance fraud.
winner
A female police officer was injured while training for her position. After she left the force, she continually cashed workers’ compensation checks while simultaneously receiving disability retirement benefits. Later, she revealed that during this time she participated in twenty-nine running competitions and participated in an intense swimming contest, finishing in record time.
Faker becomes Jail-Sitter
A guy so good at faking injuries collected 6 separate workers comp benefits for ‘related’ boos at various ‘places of employment’. He not only received almost $500,000. He finally got his comeuppance when he was caught pretending to be someone hurt in a bogus deal: twelve years in prison for false injury claims.
Workers’ Compensation, Ambulatory Surgery Centers and Hospitals
Unfortunately, the facts don’t lie. This from the Workers’ Compensation Research Institute:
Operations performed at ambulatory surgical centers are often less expensive than hospital outpatient locations! This report evaluated 2/3 of the maximum workers’ compensation payouts in the United States of America for typical operations performed at ambulatory surgical centers and hospital outpatient surgeries.