Changing Story Signals Fraud

A 35-year-old California man is charged with five felonies for his botched attempt to defraud his employer through a false workers’ compensation claim. After injuring his knee due to a weekend fall, this warehouse worker decided to spin the story into an allegation that he had injured himself while working. Integral to the investigation of this claim was coworker testimony that confirmed that this man had been limping one day before his first report to his employer, and he had admitted to the injury occurring outside of work hours. Supplementing witness statements, ICW Group’s investigation secured medical records wherein a work-related injury was denied.

ICW Group’s Special Investigations Unit packaged the gathered evidence, presenting it to San Bernardino County District Attorney’s Office. Criminal charges were filed, with a no contest plea following soon thereafter. Restitution has been ordered in the amount of $6,851.51.

Christopher Dill
Christopher Dill
Christopher Dill is the Special Investigations Unit Director at ICW Group Insurance Company. A Fraud Claims Law Specialist designee, he was a recipient of the National Health Care Anti-Fraud Association’s Investigation of the Year Award for his significant contribution to the successful resolution of “Operation Back Lash” – one of the largest workers’ compensation health care bribery schemes ever uncovered in San Diego County. Christopher has participated in over 30 criminal cases surrounding medical and legal providers attempting to defraud the Workers’ Compensation system. Christopher’s approach to insurance fraud investigations is a holistic one. From preventative education campaigns, to data analytics, to time tested investigative, and intelligence gathering techniques, it is Christopher’s belief that a multi-faceted approach to insurance fraud is necessary to a successful defense.

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