Fraud and the Workers’ Compensation System

More Than 2,700,000
Workers’ Compensation cases are filed in
America each year

Do Workers’ Compensation Insurance Carriers conspire with and are they complicit with Defense Attorneys to deny injured worker’s their benefits? The short answer is, yes. They will put into practice, devious and dishonest methods to compile a purported fraudulent case against you, including falsifying documents.

They will fabricate, remove and destroy evidence.  Your computer will be hacked and they tape private phone conversations. The carrier’s and attorney’s will falsify documents and make false police reports. They need to cast doubt on the credibility to your claim in order to successfully protect their financial interests.

Sounds Frightening? If you’re hurt at work, this can and most probably will happen to you!

The case hypothesized in this Blog, involves a real case to demonstrate the illicit activity in the workers’ compensation industry.  We have not nor will we, disclose the real names to any party discussed. Any resemblance or similarity to any actual person(s) whether living or dead, entities or events, is entirely coincidental.

We invite you to read, follow and comment as we present these issues in the workers’ compensation system. Join others by sharing your experiences.

Overview

Workers’ Compensation Insurance Carriers conspire with and are complicit with Defense Attorneys to deny injured worker’s their benefits to increase their gross profits! With over 2.7-million cases filed each year, insurance carrier’s are facing increased challenges to their financial stability. It’s the motivation Insurance carrier’s use to deny nearly every claim made by injured workers, alleging fraud, while playing the float.

Statistics show, fraud within the system is most often committed by employers, not the injured worker. What’s missing in the analysis to the published findings is, data showing fraudulent activities by carriers, which ranks higher than injured workers’ and the complicity between the carriers and attorneys to these acts.

The Insurance carriers’ deniability to a claim, shifts their financial responsibility to the city, state and federal systems, which are already overburdened. Welfare, social security disability, other social agencies and the VA are now faced with picking up the tab, from this financial shift, for injured workers. The insurance carriers become free from liability.

Insurance Carrier’s

Insurance carriers employ full time in-house professionals, including: attorneys, doctors and nurses. The carrier assesses each clim filed, independently, but most are denied, claiming in part, fraud. In one particular case, an employer caused and witnessed the electrical shock injury to his employee. But, the carrier denied the case claiming, fraud, as a preexisting injury. Consequently, once denied, a fight pursues.

The carrier employ’s an outside defense liability law firm, to litigate the claim.  The carrier will examine every aspect of your life for inconsistencies and will use it against you.  The carrier will fight, at any cost, to protect their money, even if it means fabricating a fraud claim against you!

Defense Attorney’s

Attorneys have no incentive to settle a claim quickly. This is very important! The carrier is a cash-cow and a significant amount of their gross income is derived from your pain and suffering. Attorneys are masters at manipulating facts and your pain and suffering, is immaterial to their bottom line and the financial stability of the firm.

They will sanction: wiretapping, eavesdropping, video surveillance and fabricate evidence to defend their client.  They will misrepresent material facts to cast doubt to your credibility by creating fake stories and making false and unsupported claims.

Advice in the first instance

Hurt at work? If needed, get to the hospital or call the ambulance immediately, but seek medical attention. Do not give a statement to your employer. See your doctor, get a thorough medical evaluation and file a claim with workers’ comp.  Do not talk or give a statement to anyone especially the employer’s work comp carrier when they call. They will tell you if you don’t talk to them, your claim will be denied. This is a lie!

Tell them you are seeking representation and HANG-UP! Call a work comp attorney straight-away and do not lie or fabricate the facts. Your attorney will fight to get you the medical treatment needed, lost wages and  more if necessary.

Each year there are more than 5,300,000 insurance claims filed. 2,700,000 are workers’ compensation claims and most are denied by the insurance company as fraud.

fraud, the injury, attorneys, workers' compensation

The Blog

Newly revised, the Blog exposes fraud in the workers’ compensation industry. Facts presented in this blog are from real cases involving real people. The problem is widespread and more defined legislation is needed to correct the problem.

The Blog is non bias or prejudicial to any given party, but does expose the responsible party’s. The blog focus is to reveal how insurance carriers and attorneys conspire to utilize techniques such as; computer hacking, taping of private phone conversations, video surveillance, fabricating evidence, removing and destroying evidence, falsifying documents, making false police reports and presents false and misleading documentation to the court in order to destroy your credibility and claim.

fraud, the injury, attorneys, workers' compensationThe Book

Author, Jennifer Ann Dennis, tells the true story of one individual’s workplace injury and what happened within the Workers Compensation System. It tells how he was forced to fight his case against an insurance company which had denied his claim, alleging fraud.

His story is typical of thousands of injured workers who are falsely accused of fraud each year and highlights the unethical and illegal methods which some carries use to deny benefits to claimants.

The injured worker was denied benefits including vital medical care for 11-months and became homeless based on a technicality, exploited by the carrier. When he eventually received lost wages, expenses and medical care retroactively, the insurance company further denied his rights by making additional false allegations to deny payments. Unable to afford an expensive attorney to fight a civil case, he turns to the power of social media to lure the insurance company into court in order that their lies and manipulations could be exposed and the truth be recognized. His web-Blog attracted over 11.5 million views, which the insurance company could not ignore.

It is a chilling and frightening account of the lengths to which a rich and powerful company will go to protect their money, including methods of personal surveillance, lying to a trial and a senior judge and making false police reports in order to discredit him personally by falsifying documents. It also includes 14-felony charges which the New York State Fraud Inspector General identified against the insurance company and their attorneys. When the injured worker wrote his complaint against the carrier and attorney’s, his document was fast tracked onto the fraud inspector’s desk.

There are legal accounts of fraud, misrepresentation and deceit which the reader is encouraged examine, but if you would rather not bother with such detail there is plenty of drama to engage with.

The Filmfraud, the injury, attorneys, workers' compensation

The film is a true story of an internationally recognized fashion photographer who takes on a 7-year battle against a workers’ compensation insurance company. His journey involves fraud by the attorneys representing the carrier in denying his claim after he sustained a debilitating electrical shock injury leaving him with a permanent disability. The film shows where they conspired and committed fraud by willfully misrepresenting and fabricating facts because they didn’t want to ‘pay-out’ the claim in his case.

He creates a Web-blog and uses social media such as, Twitter, Facebook and LinkedIn, to lure the carrier into a trap where he exposes them for their willful and fraudulent acts that left him homeless and penniless. He’s passionate in his determination to expose them, at any cost, for their actions.

Conspiracy, computer hacking, taping of private phone conversations, video surveillance, the fabrication of evidence, removing and destroying of evidence, falsifying documents, making false police reports and presenting false and misleading documentation to a senior judge make up this thrilling adventure into the dark side of the insurance industry. Its one-man’s fight to prove his innocence while exposing insurance carriers and attorneys for their willful fraudulent activities.

Leave a Reply

Please Login to comment
avatar
1000
  Subscribe  
Notify of

Playing the Float

Playing the Float is the lag between the time that an insurer establishes a reserve for a claim that has occurred and the time that the claim is fully paid and closed. In a workers’ compensation industry, it’s the opportunity to earn increased investment income as the lag between the filing of a claim and payment of a claim increases, thus insurers have an incentive to delay or even deny claims. The use of fraudulent tactics to delay payment on a claim, increases with each day passing. As in the hypothetical case presented in this case, that “lag” extended over 7-years.