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Concerned with the cost of fraudulent workers’ comp charges, lawmakers in California have enacted legislation to combat fraud and tighten enforcement strategies. In the process, they may have made it more likely that individuals, employers, and insurers in San Leandro would be charged with fraud in situations where the offense is not applicable.

Since the penalties for workers’ compensation fraud might be quite severe with unusually high fines, those facing or potentially facing fraud charges are advised to consult a San Leandro workers’ comp fraud lawyer as soon as possible. If retained, a diligent fraud attorney could help you protect your rights and explore your options for defending against such charges.

How State Law Defines Insurance Fraud

Workers’ compensation claims are paid by workers’ comp insurers, so workers’ comp fraud is a form of insurance fraud. When a person knowingly obtains an insurance benefit to which he or she is not entitled by lying or some other dishonest act, that behavior constitutes insurance fraud. The law also could treat persons or companies deliberately denying benefits that they know should be paid as insurance fraud. The same could be true of providers billing insurers for services that were unnecessary or never performed.

Before someone may be convicted of workers’ comp or any other form of insurance fraud, it must be proven that they acted with the intent to defraud others. The person must have known that the claim involved false information.

The California Department of Insurance dictates that if someone takes any act, such as making a misrepresentative statement with the intent to defraud, then that person has committed fraud, even if they do not obtain any actual benefit. Law enforcement may go too far or is too liberal with their definition of intent, so representation from a workers’ comp fraud lawyer in San Leandro could ensure your rights are maintained.

Types of Conduct That Might Constitute Workers’ Comp Fraud

The workers’ compensation system pays benefits for medical expenses as well as benefits to cover living expenses while an employee is unable to work. Workers’ comp fraud could involve medical expenses and general monetary benefits. Workers’ comp fraud may also involve attempts by an employer or insurer to prevent an employee from recovering benefits or doctors who wrongfully try to recover benefit payments for services or equipment.

As an attorney could explain, workers’ comp fraud has been found in cases where employees, employers or providers may have:

  • Misrepresented the number of employees they have or try to treat employees as independent contractors
  • Falsely claimed that an employment injury has left them disabled when in fact they are witnessed working or performing strenuous activities
  • Sought compensation for injuries that occurred at home or elsewhere outside the scope of employment
  • Inflated charges for medical equipment and provide kickbacks for unnecessary referrals
  • Lied about an employment accident so that a co-worker or employee will be unable to receive benefits

A San Leandro lawyer could work with you to seek out evidence proving you did not commit any workers’ comp fraud or that your employer or provider did. Evidence to prove or refute charges of workers’ comp fraud may be found recorded on devices such as cell phones or security cameras or even posted on social media.

Speaking with a San Leandro Workers’ Comp Fraud Attorney

If you were recently or might be soon charged with workers’ compensation insurance fraud, it may be important to take prompt action. Evidence to support your defense could be collected and preserved with the help of an attorney. This may include interviewing witnesses, obtaining recordings before they are erased, and gathering information about the severity of injuries or illnesses involved.

A San Leandro workers’ comp fraud lawyer who understands how these cases are handled by local courts could help prepare evidence and advocate on your behalf to help you achieve a beneficial result. To schedule a consultation and learn what an attorney could do to help, call today.

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