Workers’ Compensation Insurance Fraud: Business Situations, Injuries, Medical Claims, and the Illegal

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Unfortunately, the insurance industry has always reported incidents of fraud, whether related to home, business, auto, life, coverage, or even bonds. 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 something straight out of the 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 from 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 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 injured his arm at work and continued to collect disability benefits even after improvement and massaged clients for a fee. The US Department of Labor found out about the deception and charged him with a felony charge related to insurance fraud.

winner

A policewoman was injured while training for her position. After she left the force, she continuously cashed workers’ compensation checks while simultaneously receiving disability retirement benefits. Later, it was 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’ heckling at various ‘places of employment’. He not only received almost $500,000. He finally got what he deserved when he was caught pretending to be someone injured in a fictitious business: twelve years in jail 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 surgery centers are often less expensive than hospital outpatient settings! This report evaluated 2/3 of the maximum workers’ compensation payouts in the United States of America for typical operations performed in ambulatory surgery centers and hospital outpatient surgeries.

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