Taking a Zero-Tolerance Stance, CRMBC Wins Second Fraud Conviction in Just 9 Months
ROSEVILLE, CA, September 2, 2008 – CRMBC is proud to announce the second successful conviction for insurance fraud in nine months.
The first fraud conviction occurred in November, 2007 in Mendocino County, which was their first-ever fraud conviction. The most recent case came about in Amador County in which an employee of a CRMBC member restaurant attempted to collect disability while being employed by another restaurant at the same time. A swift and thorough investigation by CRMBC and CHSI led the county D.A. to pursue the case further. The employee was ultimately found guilty and punished with 30 days jail time, $1500 restitution of her disability payments, a $500 fine, and 3 years probation. Our service partners at Intercare Insurance Services, the program Claims Administrator, and their Special Investigation Unit, also played a key role in obtaining this conviction. Tobin Lucks, LLC, our designated law firm, has also been a strong member advocate in helping fight fraudulent and questionable claims. Our broker partners play a valuable role in helping members maintain close communications with their claims professionals.
Fighting fraud is just one of the ways CHSI and CRMBC controls your costs so that you can reinvest in your business. Ron Paine, CHSI Vice President of Risk Control & Client Service, the program administrator for CRMBC commented, “CRMBC provides members and their employees with a toll-free fraud hotline they can call anytime of the day or night, 24/7. Calls can be made anonymously, and in English or Spanish. With the help of our members and their employees, we can quickly and rigorously investigate potential fraud that may be occurring in their establishment. Rapid response and thorough investigation allows us to get vital information to prosecutors so they can pursue these cases. Fraudulent claims rob valuable resources from the legitimately injured employees.”
With your help in promptly reporting potentially fraudulent claims, we can continue to work for you to fight fraud and in doing so, keep member costs down. If you suspect a fraudulent claim, please call the CHSI Solutions Hotline: 866-521-CHSI (2474), and press 3 at the prompt.
