An employee decided that work got in the way of taking the weekend off to attend a football game with his girlfriend. Together they concocted a scheme to create a fraudulent positive COVID-19 test and claim that his exposure was work-related to get some paid time off. Because of the alleged workplace exposure, the employer had to shut down an entire week of field operations, send employees home, get everyone tested, and was left to deal with the fallout.
The employer suspected something amiss and reported the suspicions to the company’s workers’ compensation insurance carrier, ICW Group. The Claims Examiner referred the matter to the Special Investigation Unit (SIU) to find out what was happening. Working with the employer and witnesses, SIU verified that the test was fraudulent after contacting the medical facility that provided the test, refuting the workplace exposure.
The matter was referred to the California Department of Insurance and the District Attorney’s office, which resulted in the arrest of the employee and his girlfriend at a total weekend game cost of four felonies and potential restitution.