Tag: insurance claims fraud detection

A recent study conducted by the Workers’ Compensation Research Institute (WCRI) has linked the increase in Workers’ Compensation claims to high group health insurance plan deductibles. According to the research of Dr. Olesya Fomenko and Jonathan Gruber, injured workers are 1.4% more likely to file for Worker’s Compensation if they have group health deductibles worth…

CALIFORNIA ASSEMBLYWOMAN REQUESTS AUDIT OF DWC AMIDST ALLEGATIONS OF “UNDERGROUND RULEMAKING”

Apr 2, 2020

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A lawmaker in California is requesting an audit of the Department of Industrial Relations’ (DIR) after recent events uncovered suspicious activities that may be the cause of problems in the state’s Workers’ Compensation program. Blanca Rubio, Assemblywoman of the 48th District, suggested that the DIR’s Division of Workers’ Compensation (DWC) be investigated for their failure…

CALIFORNIA WORKERS’ COMPENSATION: IN SEARCH OF ANSWERS

Mar 31, 2020

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Problems have been persistent in California Workers’ Compensation over the past several years – everything from capping schemes to extended service delays have posed challenges to a program designed to assist citizens in scheduling and receiving treatment for injuries sustained in the workplace. But when the agency charged with regulating the industry is being questioned,…

SAN DIEGO LAWYER SENTENCED FOR WORKERS’ COMP FRAUD

Nov 5, 2019

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A lawyer in San Diego was sentenced to thirteen months in prison and approximately $500,000 in restitution and taxes for being part of an organized crime syndicate involved in large scale workers’ compensation fraud. Sean Enrique O’Keefe made roughly $700,000 a year sending workers’ comp claimants to medical providers that were complicit in an illegal…

Tukkomed Logic 7

Mar 15, 2019

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Tukkomed Logic 6

Mar 13, 2019

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Tukkomed Logic 4

Nov 14, 2018

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The Ethics Of Social Media Investigation In Claims Fraud

Nov 14, 2018

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Social media has become an important tool in today’s time, especially when it comes to investigations. In the legal field, social media has become a part of the discovery phase in litigation. In insurance claims, insurers have also turned to Facebook and the like in an attempt to find as much information on potential fraudulent…

TukkoMed Logic 3

Oct 19, 2018

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