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Insurance Commissioner Dave Jones and Monterey County District Attorney Announce Workers' Compensation Fraud Grant

News: 2012 Press Release

For Release: June 28, 2012
Media Calls Only: 916-492-3566
Insurance Commissioner Dave Jones and Monterey County District Attorney Announce Workers' Compensation Fraud Grant

Insurance Commissioner Dave Jones, joined by Monterey County Assistant District Attorney Stephanie Hulsey, today announced the award of a $600,000 grant by the Fraud Assessment Commission to fight Workers' Compensation Insurance Fraud. This award will assist the Monterey County District Attorney with the investigation and prosecution of fraud of this type. 

"Workers' Compensation Insurance Fraud is a serious problem that strains the system designed to protect California's workers," said Commissioner Jones. "The underground economy that is often created by this type of fraud also negatively impacts honest employers and healthy competition in California business."

Assistant District Attorney Stephanie Hulsey said, "The Monterey County District Attorney's Workers' Compensation Enforcement Team collaborates with the California Department of Insurance as well as local agencies to ensure the enforcement of the laws such as Workers' Compensation Insurance laws, which protect workers and employers."

Some of the recent cases prosecuted, include:

  • FY 2011/12 (as of 4/15/12) - 16 convictions (3 felony, 13 misdemeanor), including the conviction of chiropractor for filing false and deceptive claims;
  • FY 2010/11 - Conviction of three individuals, including one medical provider, for Employer Defrauding Employee related offenses.

Every year, the Fraud Assessment Commission determines the grant funding based on assessments placed on California employers. CDI leads the Workers' Compensation Grant Review Panel that reviews and makes grant funding recommendations based on multiple criteria including previous year performance based on application submitted by counties. Subsequently, the panel then sends a recommendation to the Insurance Commissioner who either accepts or amends the panel's recommendation. Upon completion, the Commissioner's recommendation is submitted to the Fraud Assessment Commission for their advice and consent.

CDI announced the 2013 Grants last week in a press release found at http://www.insurance.ca.gov/0400-news/0100-press-releases/2012/release077-12.cfm.

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The California Department of Insurance, established in 1868, is the largest consumer protection agency in California, regulating the $123 billion insurance marketplace. In 2013 the California Department of Insurance received more than 170,000 calls from consumers and helped recover over $63 million in claims and premiums. Please visit the Department of Insurance web site at www.insurance.ca.gov. Non-media inquiries should be directed to the Consumer Hotline at 800.927.HELP or 213.897.8921. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.

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