The California Legislature acknowledged the problem in 1992, and enacted the Insurance Frauds Prevention Act. The act was aimed at reducing fraudulent workers' compensation claims as well as other insurance fraud. The Legislature recognized that workers' compensation fraud harms employers by contributing to the increasingly high cost of workers' compensation insurance and self-insurance. Fraud can take on many forms including the failure to disclose prior injuries and settlements to an adjuster or doctor, exaggerating physical complaints, falsifying the circumstances of the alleged work injury or working for income with another employer while claiming the inability to work for the defendant employer. We are well equipped and experienced to spot the red flags of potential workers’ compensation fraud and are prepared to conduct the broader investigation necessary to determine the existence of fraud. We work in close association with law enforcement agencies, District Attorneys’ Offices and the Department of Insurance in the pursuit and prosecution of these types of cases. Our office has been successful on securing restitution orders against fraudulent employees on behalf of employers, insurance carriers and third-party administrators in the criminal courts. These Orders can be converted into an enforceable civil judgment at the end of the criminal probation and are not dischargeable in Bankruptcy. Our efforts are not limited to individuals bringing injury claims, but also have included investigation and pursuit of fraudulent medical practitioners and lawyers. |