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

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.

A 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: