Workers’ Compensation Fraud

The Insurance Fraud Unit handles workers’ compensation fraud, automobile insurance fraud, and organized automobile fraud cases. We have a team of highly motivated attorneys, investigators, and clerical support staff that are dedicated to the investigation and prosecution of these types of fraud crimes.

Fraud can occur at any time during the life of a workers’ compensation claim, from the initial filing of the claim, to statements to the employer, a doctor or other medical care person, a claim representative, physical therapist, or anyone else involved in the administration of the claim and the determination of available benefits.

It is important to know that fraud can occur even if the initial injury was legitimate and the filing of a claim warranted. Some examples of workers’ compensation fraud include an employee fabricating an injury, claiming a non-work injury as work-related, denying a preexisting injury or prior accident, denying other sources of income while receiving workers’ compensation benefits, or simply continuing to claim being injured when not, exaggerating physical disabilities or limitations, or denying the ability to do things one is able to do. It could be an employer falsifying statements to deny a claim, or falsifying records to obtain insurance coverage at a lower premium rate, or not carrying worker’s compensation insurance coverage as required by law. It may be a medical provider deliberately “over treating” on a case, or submitting fraudulent bills for payment or a lawyer operating a mill operation to generate and promote questionable cases or submitting fraudulent bills for payment.

We want to hear from you…

If you or someone you know suspects any of the fraudulent activities mentioned below, or if you are suspicious of certain activity and merely need to ask whether it is fraud, please contact us at:

HOTLINE: 916.874.4698
Insurance Fraud
906 G Street, Suite 610
Sacramento, CA 95814
916.874.8903 FAX 916.321.2219

Click here for a COMPLAINT FORM
(fill out form and then e-mail, fax, or mail to our office)

The Insurance Fraud Unit recommends the following agencies that may be of further assistance:

Department of Insurance Fraud Division

Department of Insurance Suspected Fraudulent Claims Forms

National Insurance Crime Bureau