Stolen Funds

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High Angle View Of A Person With Fractured Hand Filling Health Insurance Form

Michael Ray Williams of Daly City, Calif. has been sentenced after pleading no contest to two felony counts of insurance fraud. Williams illegally worked multiple jobs while collecting tens of thousands in workers’ compensation benefits from different insurers. 

Workers’ Compensation is a form of insurance intended to provide compensation for those who are injured while on-the-job. Those who receive benefits are placed on temporary disability and are granted wages to compensate for the time they cannot work. (It’s not meant for someone who wants to get paid for doing nothing.)

Williams claimed to sustain a work-related injury in 2014 while working as an electrician. He filed with California’s State Compensation Insurance Fund (SCIF) to collect temporary workers’ compensation benefits. He also filed another workers’ compensation claim in May 2015 through Travelers Insurance for a separate work-related injury. (One “injury” is an accident, twice is a pattern.)

The California Department of Insurance launched an investigation, which determined that Williams began to work for another employer in March 2015 while continuing to receive benefits.  (A benefits recipient is not allowed to work for a different employer during the time they are receiving workers’ compensation benefits.) In total, Williams worked at various intervals for three different employers from March 2015 to November 2016. (Sounds like he was raking in the dough.)

Williams continued to receive workers’ compensation benefits from SCIF and Travelers for his previous claims while continuing to work for different employers.  He collected over $85,000 in workers’ compensation from SCIF and Travelers Insurance, which he was not entitled to receive.  (These are funds that should have gone to people with legitimate injuries.)

Prosecutors claim that Williams misrepresented the extent of his injuries and employment status to medical providers so he could receive benefits from SCIF and Travelers Insurance. They state that he continued to make false statements to his Qualified Medical Examiner so he could receive permanent disability payments after his temporary benefits ended. (This is the adult equivalent of faking being sick to get out of going to school.)

Williams was sentenced to 60 days in county jail and three years of formal probation. (I’ve had trial subscriptions that last longer than 60 days. It doesn’t seem like a big enough punishment.)  He was also ordered to pay restitution to the SCIF in the amount of $40,000 as well as additional restitution to Travelers Insurance and his former employers.

Unrelated to his workers’ compensation fraud, Williams has been recently charged with grand theft for allegedly stealing his employer’s credit card. (Maybe Williams decided it was time to branch out into other types of crime.) He allegedly used this credit card to pay for an engagement ring and other personal expenses. (What a lucky fiancé.) Keep in mind that the grand theft charges against him are merely allegations and he is to be presumed innocent until proven guilty in a court of law.

If you suspect someone of committing Workers’ Compensation Fraud you can report it to the Office of Inspector General’s online complaint form.

Today’s Fraud of the Day comes from an article, “California Electrician Sentenced for Defrauding Workers’ Comp Providers, Employers,” published by Insurance Journal on October 22, 2020.

Michael Ray Williams, 37, of Daly City, Calif., was sentenced to 60 days in county jail and three years formal probation after pleading no contest to two felony counts of insurance fraud after illegally working for multiple employers while simultaneously collecting over $85,000 in workers’ compensation benefits from two different insurers.

Williams repaid the State Compensation Insurance Fund $40,000 in restitution and was ordered to pay additional restitution to Travelers Insurance and his former employer.

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.