A misdemeanor conviction for workers’ compensation fraud can be punished by one year of jail time. The sentence may also include a fine of approximately $150,000 or double the amount of the fraud, whichever is greater, and compensation to the employer and insurance company victimized by the fraud.
Penalties for workers facing a conviction for comp fraud are punishable by two to five years of jail time for felonies. It may also include a fine of $150,000, or double the amount of the fraud, whichever is greater, and restitution to the employer and insurance company victimized by the fraud.
Filing a false or fraudulent statement to claim benefits is an unlawful act that can be charged as a Class E felony. Workers guilty of filing a fraudulent claim shall be made to pay a fine of up to $10,000 or double the amount of the fraudulent claim, depending on which sum is more.
Repeat offenders with previous convictions for this crime are guilty of a Class D felony. The defendant’s criminal history may also impact the penalties assigned by the court for workers’ compensation fraud.
2. Penalties Against an Employer who Fails to Provide a Workers’ Comp Insurance Plan
Generally, this offense is treated as a Class A misdemeanor. However, it attracts steep penalties, including paying an amount three times the original cost of the annual insurance premium, which the employer had failed to fund, or an amount up to $50,000.
A second or repeat offense is more serious. The offender may be found guilty of a Class E felony with or without additional fines.
Injured employees in such an instance may also bring a civil suit against their employer to recoup the cost of medical treatment. A top-rated workers’ compensation attorney can provide more insight and help injured workers get compensated in such circumstances.
3. Liability of Health Care and Insurance Providers for Workers’ Comp Fraud
Liability for workers’ compensation fraud is not limited to only employers or employees. Therefore, the law makes it a criminal offense to knowingly assist or conspire with an individual to recover insurance benefits or avoid payment of benefits without cause.
Consequently, medical care providers can also commit workers’ compensation fraud if they knowingly assist employees in bringing a false claim for benefits. This may be by giving a false or fraudulent statement or material representation of an injury that never occurred to get workers’ compensation benefits.
Insurance providers may also be guilty of workers’ comp fraud if they show an intent to defraud by failing to comply with the law or fulfill their obligation to compensate an injured worker with an indisputable claim.
Other third parties who aid the commission of workers’ comp fraud may be found guilty of a misdemeanor and may be liable to pay a fine of up to $10,000.