Trends and Solutions: Workers Comp Fraud and Employer Best Practices
Employers Fraud Task Force
Workers’ comp investigators gain first-class insights directly from employers, investigators, and prosecutors. This session provided an in-depth look at emerging fraud trends, how to properly report suspicious claims, and what district attorneys look for when evaluating a case. These discussions reinforce why properly documented surveillance is critical when building a defensible fraud case, which is why our team focuses on comprehensive workers’ comp surveillance services that stand up to legal scrutiny.
The Role of the Employers Fraud Task Force
The Employers Fraud Task Force plays a vital role in combating workers' comp fraud by fostering collaboration between employers, investigators, and prosecutors. The task force provides resources and training to help employers recognize fraudulent activity and build cases that stand up in court.
This comprehensive approach to fraud prevention and prosecution ensures that fraudulent claims are detected early, reported correctly, and handled with the seriousness they deserve.
What do you do if you Suspect Workers Comp Fraud?
Unmasking Workers Comp Fraud: Insights from the Employers Fraud Task Force
Keynote Speakers:
- Dr. Tyrone Spears, California Fraud Assessment Commissioner, City of Los Angeles Workers’ Compensation
- Michael Chiriatti, Lead Deputy DA, Workers’ Comp Fraud Unit, San Bernardino County DA’s Office
- Vincent Marinaccio, Deputy DA, Insurance Fraud Unit, Orange County DA’s Office
- Lindsey Williams, Deputy DA, Fraud Unit, Ventura DA’s Office
- Jose Solorio, Detective Sergeant, Enforcement Branch Fraud Division, California Department of Insurance
Bridging the Gap: Employers, Investigators, and Prosecutors Unite Against Workers' Comp Fraud
Dr. Tyrone Spears offered a comprehensive view of fraud from the employer’s perspective, emphasizing key red flags that employers and risk managers should recognize. He underscored the importance of fostering strong relationships with healthcare providers and encouraged rigorous review of medical billing to spot inconsistencies.
Michael Chiriatti highlighted the legislative challenges in prosecuting fraud cases, explaining how lenient restitution agreements and charge reductions create minimal deterrence for fraudsters. He stressed the need for legal reforms to hold offenders more accountable.
Lindsey Williams shared practical strategies for streamlining investigations, emphasizing how well-organized data can significantly ease the workload of DA investigators. Her passion for uncovering fraud was evident as she encouraged attendees to focus on efficiency and thoroughness in case preparation.
How to report Suspected workers compensation Fraud:
The California Department of Insurance’s FD-1 Fraud Form serves as a critical tool for reporting suspected fraud. Employers and investigators can access the form here: FD-1 Fraud Form.
The top 5 Workers Comp Fraud Red Flags
How do I report workers comp fraud?
Employers, TPA's, SIU's, and insurance defense teams. Download and share this workers compensation infographic
Workers Comp Fraud or personal injury claims malingering? Continue reading
If you’re an employer, insurance carrier, or TPA and suspect a workers’ compensation claim may require further investigation, we’re here to help. Our team specializes in workers' comp fraud investigations and personal injury investigations, providing comprehensive services from initial case assessment to delivering expert testimony in court. Let us help you uncover the truth and protect your interests
Author and Los Angeles PI Ken Childs
