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 …
Tagged in: fraud
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 …
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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 …
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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, …
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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 …
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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. …
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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 …
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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. …
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