fraud | Workers’ Comp Executive

Menu

Applicant’s Attorneys Capping Scheme

Two applicant’s attorneys who pled guilty to conspiracy and multiple counts of paying for referrals of workers’ comp claimants are facing suspension from California’s workers’ comp system. The Division of Workers’ Compensation issued suspension notices to Michael Ghaemi and Bijan Favakehi, who are also facing disciplinary action by the California State Bar and a multimillion-dollar … Read More »

This content is only available to premium subscribers. Please login here log in

Updated Anti-Fraud Grant Regulations

The California Department of Insurance is circulating an amended proposal for standardizing its oversight of programs that provide grant funding to district attorneys to fight insurance fraud across multiple lines … Read More »

Workers’ Comp Fraud Bill Dies

A proposal to help insurance carriers fight workers’ comp fraud will not be moving forward this session. The measure would have given carriers access to employers’ payroll records to crack down on premium fraud, but the Assembly Appropriations Committee did not advance the bill because of cost concerns. The bill would have created a cumbersome … Read More »

This content is only available to premium subscribers. Please login here log in

Questioning DAs Anti-Fraud Efforts

For the third year in a row, California employers are paying nearly $90 million to fight workers’ comp fraud in its various forms but are getting far fewer results from district attorneys than they did when the assessment was $30 million less a decade ago. Newly compiled data show that the number of suspected fraudulent … Read More »

This content is only available to premium subscribers. Please login here log in

Legislature Enters 9th Inning

California legislators returned to Sacramento this week for the final weeks of the session with a hefty load of bills to work through. The measures of interest to the workers’ comp community include bills to enhance anti-fraud efforts, hold carriers accountable for correcting problems, and enact staffing industry reforms. Already off the table were controversial … Read More »

This content is only available to premium subscribers. Please login here log in

CDI Wants Changes to Anti-Fraud Funding

The California Department of Insurance is proposing updates to the regulations governing grant funding programs that fight fraud in workers’ compensation, automobile, disability, and healthcare insurance. The regulations haven’t been updated in decades. Tens of millions of dollars are awarded annually to county district attorneys (see related story on page 6). The Department will hold … Read More »

This content is only available to premium subscribers. Please login here log in

Commissioner, FAC Approve Funding Split Among District Attorneys

The Fraud Assessment Commission and Insurance Commissioner Ricardo Lara approved a review panel’s recommendations for splitting $55.6 million in anti-fraud funds among 30 District Attorneys. The number of DAs getting funding this year to fight workers’ comp fraud is down by two after Merced and Tulare counties did not apply this year. In 2025, Tehama … Read More »

This content is only available to premium subscribers. Please login here log in

Prosecutors & Carriers Are Failing in Anti-Fraud Results

District attorneys from around the state made their case for a share of the anti-fraud funds to a panel of experts in the field. Many DAs faced pushback for the meager results they have produced to date, but their partners in the fight against workers’ comp fraud – the workers’ comp carriers – also took … Read More »

This content is only available to premium subscribers. Please login here log in