MEWA Fraud Verdict – Finally

Five years after a federal indictment was handed down and nearly eight years after state officials first ordered an illegal workers’ comp program to cease and desist operations, a jury … Read More »

City Manager Charged with Defrauding Workers’ Comp Program

San Francisco District Attorney Brooke Jenkins filed a 62-count felony complaint against a city manager for allegedly taking over $627,000 from the city’s self-insured workers’ comp program. The charging documents allege that Stanley Ellicott used a fake vendor to bill the city for auditing workers’ comp claims and then pocketed the proceeds. As assistant director … Read More »

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

Read More »

CDI Comments On Fraud Referral Trigger

The California Department of Insurance Enforcement Branch has decided against rolling back the suspected workers’ comp fraud referral standard. Special investigations units (SIUs) are required to complete fraud investigations before making a report to the Department. The agency considered returning to the prior standard, which required referrals within 60 days of the carrier having a … Read More »

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

Read More »

Appeals Court Approves Recovery In Workers’ Comp Fraud Case

The First District Court of Appeal says a trial court was correct in allowing the Receiver in a workers’ comp premium fraud case to collect on the proceeds from a bankruptcy sale of a seized property rather than allowing the money to go to another creditor. The action was taken under Penal Code section 186.11, … Read More »

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

Read More »

Anti-Fraud Commission Approves One-Time Funding Shift

The California Fraud Assessment Commission voted for a one-time change to the formula for splitting the $90 million California employers give county district attorneys and the California Department of Insurance’s Fraud Division. The commissioners were unsure if Insurance Commissioner Ricardo Lara was asking for a permanent change to the formula or only a change for … Read More »

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

Read More »

Fight Over Fraud Funds

Insurance Commissioner Ricardo Lara is asking the California Fraud Assessment Commission to approve a change to the formula that splits employers’ assessment dollars between local District Attorneys and the Department’s anti-fraud unit. The proposal would redirect millions of dollars from the DAs to the Department of Insurance. The DAs are pushing back against the effort. … Read More »

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

Read More »

Reformulated Fraud Assessment Commission

The California Department of Insurance’s Fraud Assessment Commission is holding a special meeting tomorrow to consider a major shift in where and how the dollars are distributed in the state’s fight against workers’ comp fraud (see related item on page 1). Five commissioners reviewed the proposal at the Commission’s January 10th meeting, but it is … Read More »

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

Read More »

SIU Fraud Reporting Rollback

The California Department of Insurance is floating the idea of undoing a change to the reporting rules for special investigations units (SIUs) amid concerns that the current standard undermines some prosecutions. The Department backed a change to the insurance code to get more complete reports of suspected fraudulent activity, but there are now new issues. … Read More »

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

Read More »