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TABLE
OF CONTENTS
Overview
Contact
information
2005
law on workers' compensation fraud
WC
Fraud Unit's annual reports
Overview
It
is illegal for anyone—a worker, employer, insurance carrier,
medical provider, etc.—to intentionally do any of the following:
• Make a false claim for any w.c. benefit;
• Make a false statement in order to obtain or deny benefits;
• Make a false statement in order to prevent someone from
filing a legitimate claim;
• Make a false certificate of insurance as proof of insurance;
• Make a false statement in order to obtain w.c. insurance
at less than the proper rate;
• Make a false statement in order to obtain approval to self-insure
or reduce the security required to self-insure;
• Make a false statement to the state’s fraud and noncompliance
investigation staff in the course of an investigation;
• Help someone commit any of the crimes listed above;
•
Move, destroy, or conceal assets so as to avoid payment of a claim.
A “statement” includes any writing, notice, proof of
injury, or any medical bill, record, report, or test result.
Anyone
found guilty of any of these actions is guilty of a Class 4 felony,
punishable by 1-3 years imprisonment and a $25,000 fine. The guilty
party shall be required to pay complete restitution, and may be
found civilly liable for up to three times the value of benefits
or insurance coverage that was wrongfully attained.
Contact
information
If
you would like to report a suspected case of workers' compensation
fraud, contact Francis "Buzz" Walsh in the Workers' Compensation
Investigative Unit at the Illinois
Department of Financial and Professional Regulation/Division
of Insurance (francis.walsh@illinois.gov;
toll-free 877/923-8648; 320 W. Washington, Springfield, IL
62786).
You
will be required to identify yourself and, at some point, the person
you are reporting will be given your name. Anyone who intentionally
makes a false report is guilty of a Class A misdemeanor, punishable
by up to 12 months imprisonment and a $2,500 fine.
WC Fraud
Unit's annual reports
2008
annual report
2007
annual report
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