|
Workers' Compensation Fraud
The Insurance Fraud
Unit handles workers' compensation fraud, automobile insurance fraud, and
organized automobile fraud cases. We have a team of highly motivated
attorneys, investigators, and clerical support staff that are dedicated to
the investigation and prosecution of these types of fraud crimes.
We want to hear
from you...
If you or someone
you know suspects any of the fraudulent activities mentioned below, or if
you are suspicious of certain activity and merely need to ask whether it is
fraud, please contact us at:
HOTLINE: (916) 874-4698
OR
Insurance Fraud
906 G Street,
Suite 610
Sacramento, CA 95814
(916) 874-8903 FAX (916) 874-9054
InsuranceFraud.DA@sacda.org
COMPLAINT FORM
(To file a complaint,
please click on “COMPLAINT FORM.” Fill out
form and then e-mail, fax, or mail to our office.)
Overview
Fraud can occur at
any time during the life of a workers' compensation claim, from the initial
filing of the claim, to statements to the employer, a doctor or other
medical care person, a claim representative, physical therapist, or anyone
else involved in the administration of the claim and the determination of
available benefits.
It is important to
know that fraud can occur even if the initial injury was legitimate and the
filing of a claim warranted. Some examples of workers' compensation fraud
include an employee fabricating an injury, claiming a non-work injury as
work-related, denying a preexisting injury or prior accident, denying other
sources of income while receiving workers' compensation benefits, or simply
continuing to claim being injured when not, exaggerating physical
disabilities or limitations, or denying the ability to do things one is able
to do. It could be an employer falsifying statements to deny a claim, or
falsifying records to obtain insurance coverage at a lower premium rate, or
not carrying worker's compensation insurance coverage as required by law. It
may be a medical provider deliberately "over treating" on a case, or
submitting fraudulent bills for payment or a lawyer operating a mill
operation to generate and promote questionable cases or submitting
fraudulent bills for payment.
Related Contacts
Department of
Insurance Fraud Division
(916) 854-5700
Department of Insurance Suspected Fraudulent Claims Forms
National Insurance Crime Bureau
|
