along with the employer's full knowledge so they could have surgery so worker-comp insurance would pay for it.and then at the same time took out pay-check protection insurance policy to get extra money while they wern't working on the worker-comp injury,and then continued to work and be paid under the table so to speak what could they expect to happen to them leagally if found out?
2007-03-16 07:07:55 · 7 answers · asked by Gramps 1 in Business & Finance ➔ Insurance
I assure everyone this is not something I have done I just hear about it being done.
2007-03-16 09:48:21 · update #1
Its not what your employer says that workers comp is going to look at. It is the physicians notes that the insurance company is going to look at. The first thing the surgeon is going to say in his consultation is that you have a pre-existing condition that has progressed to the point that you need surgery. Do you have disability insurance? Thats to cover you if you are out on surgery. Workers comp will only pay if you are hurt on the job. Two different coverages...I suggest you find out what is what before you try to defraud the insurance company. Workers comp is hard enough to get when a claim is filed with good intentions.
2007-03-16 09:24:08 · answer #1 · answered by withluv7 3 · 0⤊ 0⤋
They could expect to be prosecuted for insurance fraud. Along with their employer who had knowledge of what they were doing and conspired along with them to defraud the insurance companies.
Insurance claims departments report claims to the index system. If you've already had a prior claim on your back, they'll know that as soon as the index report comes back. Not to mention, when you then file the disability claim, they'll also know so you will have tried to defraud two insurance companies. I'd say that should get you about 3 or 4 years in prison. But, you could probably have your back surgery done for free in the prison system.
Not to mention, the employer is an idiot for going along with this as Workers Compensation premiums are experience rated so his rates will go up.
2007-03-16 07:12:44 · answer #2 · answered by Faye H 6 · 1⤊ 0⤋
They can be required to pay back every time that was paid to them or on their behalf. Depending on the size of the fraud, jail time is possible.
You're also talking about tax evasion, and jail time is possible for that, not to mention penalties & fees.
Workers comp is NEVER pre-approved. So just because the employer said ok, doesn't mean that the comp carrier is actually going to pay for it.
So now, when you hear people complain about how high rates are, you can think of "some person" and their cheating employer, and know why.
2007-03-16 07:14:41 · answer #3 · answered by Anonymous 7 · 1⤊ 0⤋
You said a pre-existing now did this injury occur during work? You didn;t say. You said your employer knows about this so he's backing you up in this little fraud scam of yours. Take a look at the laws governing fraud. It could meen jail time, and or a fine and plus you'll have to pay it all back.
I pay for WC through taxes maybe I should just report you and your employers stupid scam to the proper authorities its not that I'm a stool pigeon but your stealing off of other tax payers.Jerk
2007-03-16 07:17:56 · answer #4 · answered by idak13 4 · 0⤊ 0⤋
of direction you could report, yet will the declare be authorized? it rather is an entire new question, yet one, thankfully for you, that I do have an answer for. you will want a Workman's comp lawyer, yet no longer basically any lawyer. of direction you like a stable Workman's comp lawyer. it extremely is the place we are available in at Dewey, Cheatem and Howe. suited Workman Comp attorneys around. only dial 555-1212
2016-10-18 13:12:11 · answer #5 · answered by ? 4 · 0⤊ 0⤋
Go to prison. Everything you mentioned is fraud.
2007-03-16 07:12:04 · answer #6 · answered by ? 7 · 2⤊ 0⤋
It is fraud. I believe that is a felony.
2007-03-16 10:43:28 · answer #7 · answered by mamatohaley+1 4 · 0⤊ 0⤋