Restitution Paid in Santa Barbara WC Fraud Case

June 16, 2004

According to IHI Insurance Services, a recent fraud conviction in a workers’ compensation claim resulted in $12,224 in restitution, 90 days in jail, and three years of formal probation. This award followed the guilty plea of a workers’ comp claimant on one count of insurance fraud, in violation of Insurance Code 1871.4(a) (1), for making false or fraudulent written or oral statements.

Adjusting a workers’ comp claim on behalf of the California Insurance Guarantee Association, IHI and its workers’ comp division, Intercare Insurance Services, assisted in the Santa Barbara County District Attorney’s investigation and plea bargain by Santa Barbara resident Leopoldo Navarro, 39, a former employee of McConnell’s Fine Ice Cream.

Navarro, who pleaded guilty to insurance fraud, had alleged that he was disabled from work at McConnell Fine Ice Cream while at the same time working for another employer.

“IHI is committed to investigating and fighting all types of insurance
fraud in the State of California,” said Kevin Hamm, CEO of IHI Insurance Services and its Intercare division. “Workers’ comp fraud is a plague on the businesses in California. It drives up rates, harms employees with legitimate claims and further erodes a California’s workers’ comp industry already in crisis. We protect our clients at every turn and go after insurance fraud with tenacity.”

IHI’s Special Investigation Unit investigates all types of workers’
comp insurance fraud. Over 80 percent of the claims submitted to District Attorney Offices by Intercare have resulted in the filing of criminal complaints. IHI and Intercare sent 15 cases to district attorneys throughout California in 2003.

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