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Fraudulent Food Poisoning Claims By Wayward Brits Hurting Spanish Hoteliers
By Lonce LaMon - April 24, 2017

Just ten days ago, a Los Angeles area injured worker, Rev Anthony T. Johnese, wrote to this writer and inquired, “I was curious to know if you ever write about fraud from adjusters, lawyers, or insurance carriers.”  I wrote back and replied that I did. I pointed him to a few articles I had penned back in 2009 about three experienced Southern California workers’ compensation claims adjusters, Hector Porrata, Cara Cruz-Thompson, and Rene Montes, who had embezzled over a million and a half dollars from A.I.G. and Matrix Absence Management. They were prosecuted by the Orange County District Attorney’s office.

Deputy District Attorney Shaddi Kamiabipour Takes On A New Workers' Compensation Fraud Case In Orange County. Tanya And Christopher King, With Three Medical Companies, Allegedly Billed Workers' Comp Payers Over $40 Million Fraudulently And Illegally.
By Lonce LaMon - April 21, 2017

Deputy District Attorney Shaddi Kamiabipour, of the Orange County District Attorney’s office, has just taken on yet another significant workers’ compensation fraud case as the lead prosecutor.

This new case now centers around a married business couple, the Kings—Tanya Moreland King and Christopher King—who are from Beverly Hills, California.   They are attractive and only in their late thirties.  

The Kings ran the medical businesses of Monarch Medical Group, Inc., King Medical Management, Inc., and One Source Laboratories which the California Insurance Commissioner and the Orange County District Attorney have shut down after approximately 40 million dollars in illegal and fraudulent billings having been presented to workers’ compensation payers between 2011 and 2015.  Of that $40 million billed, approximately $23.2 million has been paid to the defendants.

Ohio Hit Hardest By Opioid Dependence Insurance Claims
By adjustercom - April 19, 2017

Insurance claims for heroin overdoses and opioid dependence are surging in Ohio, one of the states hit hardest by rising rates of opioid abuse and overdose deaths, according to a report released on Wednesday.
Private claims for diagnoses including opioid abuse, opioid dependence, heroin overdose and overdose of opioids excluding heroin rose by 770 percent across Ohio between 2007 and 2014. Increases were seen throughout the state, however Ohio’s five major cities were responsible for the majority of claims made over that time period.

Whistleblower Surfaces As AmTrust Denies Federal Investigation
By Lonce LaMon - April 16, 2017

AmTrust Financial Services Inc., a multi-national insurer which includes an insurer and handler of workers’ compensation claims in California, has recently been the subject of a federal investigation into its accounting practices aided by an auditor who worked for the accounting firm BDO USA L.L.P., that audited AmTrust in 2014.

AmTrust provides property-casualty and workers’ compensation insurance for small to mid-sized businesses. The company reported $5.92 billion in direct written premiums in 2015, including $2.97 billion in workers compensation direct written premiums, according to a report released last month by rating agency A.M. Best Co. Inc.

More News

April 11, 2017 - The Nation Together With California Takes On The Opioid Addiction Problem With Injured Workers.

April 5, 2017 - Christine Baker, Director of California Department of Industrial Relations (DIR), comments on WCIRB Rate Cut Recommendation

April 4, 2017 - New Mexico Governor Signs Senate Bill 155 Which Sets Limitations On Workers’ Compensation Benefits

April 3, 2017 - California Office of Administrative Law Approves Division of Workers' Compensation's Final WCIS Medical Billing, FROI/SROI Reporting Regulations

March 31, 2017 - Two Sisters, Sung Hyug Kim and Caroline Sung Choi, Designer Jeans Manufacturing Executives, And Their Accountant, Are Sentenced For Workers' Compensation Fraud In Downtown LA Court

March 26, 2017 - What's Going On With The Sim Hoffman M.D. Case In Orange County? A Ruling From The California Supreme Court, That's What.

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