Joint Investigation Nabs Louisiana Workers’ Comp Fraudster

Louisiana’s Office of Workers’ Compensation Administration (OWCA) reported recently that an attempt to cheat the state’s workers’ compensation insurance program has resulted in a prosecution and guilty plea, and serves as a warning to others who attempt to misuse the program that they will be investigated and where appropriate, prosecuted.

A joint effort by the Louisiana Department of Labor’s Office of Workers’ Compensation Administration and the State Attorney General’s Office resulted in the prosecution of a Jennings man.

Hank Bourque, 49, pleaded guilty to felony theft in a Jefferson Davis Parish courtroom in May for filing a false workers’ comp claim. Bourque was ordered to make restitution in the amount of $48,900 to the Wausau Insurance Company for lost wages and medical expenses it paid to him.

In February 2000, Bourque reported that he hurt his back while loading a set of concrete stairs onto the back of a pickup truck for his employer, the Jefferson Davis Parish School Board.

A joint investigation conducted by the LDOL’s Office of Workers’ Compensation and the Attorney General’s Office found that while Bourque was present when the stairs were being loaded, he was not physically involved in loading them.

According to the WCA, the investigation determined that Bourque filed a false claim to cover medical expenses he incurred from a prior non-work-related physical injury.

In addition to repaying $48,900 to Wausau Insurance Company, Bourque received a two-year suspended jail sentence and five years of supervised probation for which he must pay a $50 monthly supervision fee.

“The medical benefits and lost wages fraudulently obtained by Bourque were substantial, but it’s still just a drop in the bucket compared to all of the illegally received workers’ compensation benefits,” said Kaye Fournet, of the Fraud Division of the Office of Workers’ Compensation Administration. “Bourque’s prosecution will hopefully serve as a deterrent to others who might be tempted to cheat the system.”

Workers’ comp fraud costs the insurance industry and employers billions of dollars each year.

“Ten cents out of every premium dollar is wasted on workers’ compensation fraud,” Fournet said. The cost drives up prices for consumers and results in the downsizing and closure of some companies.

The OWCA’s report on first quarter 2004 fraud claim activity showed that during the first quarter of 2004, 556 fraud claim investigations were initiated and 538 were completed.

Those investigations resulted in one referral for prosecution and two arrests/prosecutions. Of the investigations initiated during the first quarter. 97 percent were completed within 30 days.

During 2003, the agency initiated 2,379 fraud claim investigations, completing 2,262 of them, according to the Office of Worker’s Compensation 2003 Annual Report.

Those investigations resulted in seven convictions and seven referrals for unemployment insurance fraud.