California Commissioner Awards $34.9M to Fight Workers’ Comp Fraud

October 13, 2016

California Insurance Commissioner Dave Jones today announced he has awarded $34.9 million in grants to 37 district attorney offices representing 44 counties across California to combat workers’ compensation insurance fraud.

The grants, funded through employer assessments, support law enforcement efforts in investigating and prosecuting workers’ compensation insurance fraud.

Grant funding is based on assessments from California insured and self-insured employers, and district attorneys apply for workers’ comp fraud grant funds.

fraud-roundupA panel reviews the applications and makes funding recommendations to the commissioner, based on multiple criteria, including past performance, the county’s problem statement, and their program strategy for the upcoming year. The commissioner’s recommendation is submitted to the Fraud Assessment Commission for their advice and consent, and then the grants are awarded.

Workers’ comp fraud includes medical provider fraud, employer premium fraud, employer defrauding employee, insider fraud, claimant fraud, and the willfully uninsured operating in the underground economy.

“Ultimately California consumers and businesses pay the price for insurance fraud through higher premiums and increased costs for good and services,” Jones said in a statement. “These grants will assist district attorneys across the state in uncovering workers’ compensation fraud schemes and prosecuting those who take advantage of the system.”

California Department of Insurance Workers’ Compensation Insurance Fraud Grant Program funding for fiscal year 2016-2017 is as follows:

Alameda $1,511,933 Sacramento $952,027
Amador $393,896 San Bernardino $1,968,662
Butte $76,378 San Diego $5,028,198
Contra Costa $864,000 San Francisco $758,121
El Dorado $292,828 San Joaquin $472,972
Fresno $1,116,000 San Luis Obispo $54,419
Humboldt $200,000 San Mateo $677,353
Imperial $125,450 Santa Barbara $331,499
Kern $752,904 Santa Clara $2,626,811
Kings $263,875 Santa Cruz $49,000
Los Angeles $6,729,177 Shasta $137,307
Marin $245,000 Siskiyou $46,832
Merced $175,209 Solano $169,476
Monterey $660,000 Sonoma $82,120
Napa $123,609 Tehama $112,127
Nevada $75,049 Tulare $501,165
Orange $4,152,802 Ventura $708,652
Placer $175,000 Yolo $257,010
Riverside $2,084,970 Total $34,951,831

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