Each week we'll be surveying what the media, state agencies, insurance companies, and others report in terms of workers' comp fraud. Just like a police blotter, our workers' comp fraud blotter lists recent arrests, charges, convictions and investigations.
Workers' Comp Fraud Blotter - May 24, 2012
Newly Retired Police Officer Charged With Mail Fraud and Health Care Fraud (NY) - Patrick S. O'Mara, who recently retired as a Buffalo Police Officer, has been arrested on a criminal complaint for mail fraud and health care fraud. Mara was placed on Injured on Duty Status in 2004 as a result of exacerbation of cervical and lumbar strains that were sustained while on duty. He returned to work on light duty, but he was placed on Injured on Duty Status again after he claimed that he injured his right arm while lifting two reams of copy paper. The complaint charges that while Mara claimed that he was unable to work, he was working as a paid musical director and church organist and using his right arm. Read more
Workers' Comp Audit Supervisor Charged With Taking Bribes From Employers (PA) - James McDonnell, an audit supervisor for the Pennsylvania State Workers' Insurance Fund, has been charged with bribery for allegedly taking more than $80,000 in kickbacks from Pennsylvania employers in exchange for promises that he would reduce their workers' compensation premiums. Read more
Roofing Company Owners Plead Not Guilty To Insurance Fraud (CA) - John Applegate and Camille Applegate, the owners of Hallmark Roofing, Inc., have pled not guilty to 24 felony counts of workers' compensation fraud and five felony counts of tax evasion. The Applegates are accused of failing to accurately report their employee wages to their workers' compensation insurance insurer and thus underpaying their workers' compensation insurance premiums by hundreds of thousands of dollars. Read more
Insurance Broker Admits Sending Fraudulent Insurance Invoice To Housing Authority (PA) - Kobie T. West, a broker with West Insurance Group, has pled guilty in federal court to wire fraud for creating a $2,141,523 fraudulent invoice for workers' compensation insurance for the Philadelphia Housing Authority. West received a check for $2.3 million from the housing authority, which also included a $181,202 commission for the fraudulent insurance. Read more
Roofer Going To Jail In Both Washington and Montana (WA) - Roofing contractor John Mulinski, who took money from numerous unsuspecting consumers but failed to deliver a completed project, has now pled guilty in state court in Washington to theft. He had previously pled guilty in federal court in Montana to similar fraud charges and was sentenced to 5 years in prison. His plea agreement in the state court sets his maximum jail sentence to 70 months. Read more
Janitorial Service Business Owner Sentenced To Probation and Ordered To Make Restitution (OH) - Phil Kraus, the owner of KC Berkshire, a janitorial service, has been sentenced to 18 months of community control and ordered to pay $91,555 in restitution for failing to pay more than $90,000 of workers' compensation insurance premiums. Kraus was originally investigated for under-reporting his business' payroll, which was used to calculate his insurance premium. Kraus amended the payroll reports and agreed to enter into a reinstatement payment plan to pay overdue premiums. He then failed to make the payments and continued to operate his business without coverage. Read more
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