An electrician was injured at work. He needed surgery and could not work. Accidents happen – that’s why employers have workers’ compensation insurance…or not.
The employer tried to provide benefits directly. The claimant hired an attorney.
The case came to our sister company, American Claims Management (ACM) late, preventing their claims and medical staff from having their full effect in helping the claimant recover; they turned the investigation over to us. Now, it’s in litigation.
The employer admitted knowing of the injury. He told our investigator that he intentionally prevented the case from being referred to ACM, to keep his ex-mods and future premiums down.
In workers’ compensation, that’s a felony. The prosecutor and judge agreed.
The business owner was arraigned at the Los Angeles County Superior Court for insurance fraud. And our carrier client is no longer on the risk. Case closed on our books.