Commit Workers’ Compensation Insurance Fraud, and It Will Cost You

In early 2022 we told you about an upholsterer who was caught working another job under a different identity while earning disability benefits. ICW Group’s Special Investigation Unit (SIU) launched an investigation after receiving a call from our policyholder customer. Our policyholder was contacted by the upholsterer’s new employer and notified that the worker was working for them and telling others about his workers’ compensation claim.

The investigation revealed the worker earned almost $11,000 at his new job, all the while collecting over $6,000 in disability benefits from ICW Group. Despite having never reported this new income, as required, he also lied about earning new income while under oath at his deposition and denied being able to find any work because of his injuries.

Because of the material misrepresentations made by the injured worker, SIU referred this matter to law enforcement. Following its own criminal investigation, the District Attorney filed felony charges against the former upholsterer. In the end, the defendant pleaded no contest to one felony count of insurance fraud. He was ordered two years of probation, 200 hours of community service, and $36,698 in restitution paid to ICW Group.

Lindsey McLain
Lindsey McLain
Lindsey is a Supervisor in the Special Investigation Unit at ICW Group. Lindsey has investigated 100s of cases; many resulting in criminal charges filed by state prosecutors, and thousands of dollars in restitution paid to ICW Group. In addition to conducting fraud investigations, she also presents and produces anti-fraud training for ICW Group personnel, and hosts fraud prevention webinars that reach thousands of customers nationwide.

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