Workers' Comp Fraud Blotter (5/31/2012) – AIG Fined; Largest Fine in Pennsylvania Insurance Department’s History Levied

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 31, 2012

Pennsylvania Insurance Department Levies Fine Against AIG; Largest Fine in Agency's History (PA) - Pennsylvania Insurance Commissioner Michael Consedine has announced that American International Group Inc., AIG, and its workers compensation insurance affiliates will pay Pennsylvania more than $16.8 million in fines and assessments, including $8.6 million in fines, $3.6 million to the Workers' Compensation Security Fund, and $4.6 million in premium taxes and assessments, as a result of a settlement agreement in a multi-state probe that examined whether AIG violated premium reporting rules governing workers' compensation insurance. The Pennsylvania settlement is part of a nationwide agreement whereby AIG will pay a total of $100 million in penalty, as well as $46.5 million in additional premium taxes and assessments, to all of the participating states prior to the end of June.   Read more

Security Guard Hid Previous Knee Surgery and Treatment (OK) - William R. Richmond has been charged with three counts of workers' compensation fraud after filing workers' compensation claims that stated he had no prior knee injury. Richmond sought medical treatment and filed three claims, for injuries to both knees and his left shoulder, when he slipped while working as a security guard. Richmond repeatedly claimed no prior injury or treatments to his left knee, although he had a previous surgery on his left knee in 2009.   Read more

Two Businessmen Charged With Workers' Compensation Fraud and Conspiracy (CA) - Erick Gamm and Gregory Santolucito have been charged with conspiracy and three counts of workers' compensation fraud for allegedly misrepresenting to their insurer the kinds of work or tasks their employees performed. They are accused of conspiring to defraud First Comp Insurance of over $100,000 in unpaid insurance premiums by falsifying employee wages.   Read more

Claimant Denied Having Previous Pain In His Back (OK) - John Caughlin has charged with three counts of workers' compensation fraud and one count of pattern of criminal offenses. Caughlin sought medical treatment in November 2010 and filed a workers' compensation claim for an injury to his back that allegedly occurred while on the job. On several occasions, Caughlin stated he had been seeing a doctor for an issue with his neck and cervical spine, but he repeatedly denied any prior problems with his upper back, even though medical records showed that he had claimed pain to his upper back prior to the alleged accident.   Read more

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