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Charges Filed In Alleged SJDB Fraud Ring

The Los Angeles County District Attorney filed charges against six individuals alleging insurance fraud and labor code violations related to the Supplemental Job Displacement Benefit program. Prosecutors allege executives at the Caledonian Vocational School paid kickbacks to vocational counselors for referring injured workers and then cheated the workers out of their SJDB benefits. Guillermo Frias, … Read More »

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33 DAs Receive Anti-Fraud Funds

Some $52,479,138 was awarded to 33 district attorneys around the state to fight workers’ compensation fraud. The funding includes nearly $5.4 million that was awarded to the DAs last year but was not spent. California employers pay $90 million per year to fight workers’ comp fraud through assessments on workers’ comp premiums or directly to … Read More »

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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 »

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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 »

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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 »

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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 »

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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 »

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