Fraud of the Week

March 13, 2017

Workers Comp Fraud—Texas

Amount: $408,000

 

Half of a scheming duo was sentenced last week to 21 months in prison for his role in a scheme to defraud the Department of Labor's Office of Workers' Compensation Program. The co-defendants were both former employees of the U.S. Postal Service (USPS). The male co-defendant had been a USPS employee since 1982, had filed 8 workers comp claims, and stopped working in 2007 while continuing to receive workers' compensation benefits until 2009. He had received over $68,000 in benefits at the time of his retirement in 2009 and continued to receive disability medical care until recently. The female co-defendant started working for USPS in 1985 and filed disability claims in 2001, 2003, and 2008. She was placed on workers compensation in 2001 and received disability retirement in 2011. She received more than $340,000 in workers compensation payments. Both were found guilty of falsifying medical documents for $100 per document in a much larger medical fraud scheme of a convicted co-conspirator who falsely billed the government for over $11.4 million. The female fraudster will be sentenced in June 2017.

 

This premium content is locked for FC&S Coverage Interpretation Subscribers

Enjoy unlimited access to the trusted solution for successful interpretation and analyses of complex insurance policies.

  • Quality content from industry experts with over 60 years insurance experience, combined
  • Customizable alerts of changes in relevant policies and trends
  • Search and navigate Q&As to find answers to your specific questions
  • Filter by article, discussion, analysis and more to find the exact information you’re looking for
  • Continually updated to bring you the latest reports, trending topics, and coverage analysis