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WORKERS’ COMPENSATION FRAUD ARRESTS
Many members are concerned about the high cost of
Workers’ Compensation and the insidious cost of fraud. Good news: The State
Insurance Fund, the underwriter of the United Restaurants of New York
Workers’ Compensation Safety Group #556, is fighting back.
The State Insurance Fund has done more to fight fraud
then all of the other carriers combined when measured by arrests. Their goal
is to reduce the cost of fraud for everybody’s benefit.
For example, a Long Island, N.Y. business owner was
recently sentenced to six months in jail after pleading guilty to attempted
violation of the Workers’ Compensation law, in a case of premium fraud
against the NYS Insurance Fund.
This roofing company employed several more workers than
the number disclosed in their application for insurance and payroll records
submitted to the NYS Insurance Fund. Investigators said that the company
understated payroll to obtain a lower insurance premium, owing the NYS
Insurance Fund $113,000.
The owner was
arrested and charged with a violation of Section 114 of the Workers’
Compensation Law which
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is a felony. The owner pleaded guilty to a misdemeanor
and was sentenced to six
months in jail and ordered to pay restitution of
$89,000.
In a separate matter, a former City of Binghamton water
department employee was sentenced to 1.5 to 3 years in state prison for
falsely reporting a workers’ compensation claim. The claimant said he
damaged his knee in a work related accident when instead he injured his knee
during a domestic dispute.
The claimant was convicted of one count of fraudulent
practices and one count of offering a false instrument for filing. Both
charges are felonies. “This sentence, which includes prison time, should
serve as a stark reminder to anyone thinking about workers’ compensation
fraud, that it is simply not worth the risk,” said Donna Ferrara, chairwomen
of the Board.
If you suspect that any of your employees are filing
fraudulent claims, please call the Friedlander Group, our safety group
manager, immediately. Call Laura Thorpe, Claims Manager, at 914-694-6000,
ext. 227.
It’s important to take fast action to be effective in
establishing that a claim is in fact fraudulent. Taking action also sends a
message to others that there is accountability and recourse.
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