False Accusation Leads to Insurance Fraud Charge

A California woman filed a workers’ compensation claim against her employer for injuries after allegedly being struck by a 10-pound object thrown at her by a co-worker. As a result of the impact from the object, she complained of anxiety, neck pain, and difficulty sleeping.

Following the allegation reported by the woman to her employer, the co-worker admitted to playfully throwing an object at her but disputed the item weighed 10 pounds. In collaboration with the employer and ICW Group’s Special Investigation Unit (SIU), an investigation found the object to be a small plastic cap weighing less than one ounce.

Additionally, surveillance provided by the employer showed the entire incident and refuted the injured worker’s version. In the video, the object never struck her body, and the claim was denied and closed after minimal medical treatment had been rendered.

SIU referred the case to law enforcement, and the woman was charged with one count of insurance fraud. 

When it comes to workers’ compensation fraud, employers are often the first line of defense in mitigating and defeating a potentially fraudulent claim. You can find helpful fraud education and prevention resources on ICW Group’s Policyholder Center. You can access various materials and reference guides to assist you during a claim investigation and guide you toward the next steps once a claim looks suspicious.

If you have any questions or suspicions about fraud, call the ICW Group’s anti-fraud hotline at 855.ICW.FRAUD (855.429.3728) or email us at fraudunit@icwgroup.com. All statements are confidential and available only 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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