Alleged disability fraud thwarted by Department of Insurance detectives
News: 2021 Press Release
SACRAMENTO, Calif. — John Swank, 58, was arraigned on multiple counts of insurance fraud and grand theft after allegedly claiming to be too ill to work and simultaneously collecting over $60,000 in disability insurance payments he was not entitled to because he began working for other employers. The alleged fraud was uncovered by Department of Insurance detectives who seek to protect both consumers and businesses from false claims and fraudulent practices.
In April 2015, Swank, a bird specialist with a local pest control company, submitted disability claims forms to his employer for intestine and heart issues. The Long Term Disability (LTD) policy, which Swank purchased through his employer a year earlier to cover illnesses or injuries that are not work related, stated if a claimant was disabled and working that they would receive a weekly payment if their weekly disability earnings if any, were less than 20 percent of their weekly earnings. The policy also stated that LTD payments would stop the date the disability earnings exceed the amount allowable under the plan.
Swank collected LTD payments from June 2015 to July 2019, totaling approximately $105,800.
An investigation by the California Department of Insurance revealed in November 2018, Swank stated he had not returned to work in a disability status update to his employer’s insurance company handling his claim. However, the investigation found that Swank had worked for several different pest control companies between January 2017 and 2020, which resulted in him receiving $63,387 in disability payments he was not entitled to receive.
Swank’s original employer’s insurance company sent him a denial letter stating due to his return to work he was no longer eligible for LTD payments as of January 6, 2017, because his earnings had been greater than the policy allowed.
Swank self-surrendered to the Sacramento County Main Jail and was arraigned on July 15, 2021. The Sacramento County District Attorney’s Office is prosecuting this case.
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The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $340 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $469 million in claims and premiums. Please visit the Department of Insurance website at www.insurance.ca.gov. Non-media inquiries should be directed to the Consumer Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.