Workers Compensation Abuse Case Study
The New York State Insurance Fund arrested two Long Island builders and one claimant in separate cases of alleged workers compensation fraud with a potential total of more than $1 million.
All three arrests took place last week, resulting from joint investigations by the Suffolk County District Attorney Insurance Crime Unit, the New York State Insurance Department Frauds Bureau, the Workers' Compensation Board Fraud Inspector General's Office and NYSIF's Division of Confidential Investigations.
"NYSIF has mounted an aggressive campaign against workers' compensation fraud for many years thanks to the cooperation and assistance of our investigative counterparts at other agencies and the law enforcement community throughout New York State," NYSIF Chief Deputy Director Francine James said.
Monica …show more content…
The unit's formal name will be the Medical Review and Abuse Unit of the Workers' Compensation Division of the Oregon Insurance and Finance Department.
The decision to set up the hotline and investigative unit came in the wake of a test last year to gauge the level of possible fraud and abuse of workers' compensation.
Allegations from callers pointed to possible abuse in many quarters, including medical providers, workers, employers, attorneys, insurers, and vocational rehabilitation providers.
He went on to say that the division "is currently drafting changes in workers' compensation regulations which will increase its ability to closely monitor the performance of medical providers, investigate instances of abuse, and impose the appropriate sanctions when violations are verified." He noted that the right of six firms to write new workers' compensation coverage in Oregon had been suspended because of repeated instances of poor service to claimants and disregard for workers' compensation laws and
All three arrests took place last week, resulting from joint investigations by the Suffolk County District Attorney Insurance Crime Unit, the New York State Insurance Department Frauds Bureau, the Workers' Compensation Board Fraud Inspector General's Office and NYSIF's Division of Confidential Investigations.
"NYSIF has mounted an aggressive campaign against workers' compensation fraud for many years thanks to the cooperation and assistance of our investigative counterparts at other agencies and the law enforcement community throughout New York State," NYSIF Chief Deputy Director Francine James said.
Monica …show more content…
The unit's formal name will be the Medical Review and Abuse Unit of the Workers' Compensation Division of the Oregon Insurance and Finance Department.
The decision to set up the hotline and investigative unit came in the wake of a test last year to gauge the level of possible fraud and abuse of workers' compensation.
Allegations from callers pointed to possible abuse in many quarters, including medical providers, workers, employers, attorneys, insurers, and vocational rehabilitation providers.
He went on to say that the division "is currently drafting changes in workers' compensation regulations which will increase its ability to closely monitor the performance of medical providers, investigate instances of abuse, and impose the appropriate sanctions when violations are verified." He noted that the right of six firms to write new workers' compensation coverage in Oregon had been suspended because of repeated instances of poor service to claimants and disregard for workers' compensation laws and