Stolen Funds

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High Angle View Of A Person With Fractured Hand Filling Health Insurance Form

Michael Ray Williams of Daly City, Calif. has been sentenced after pleading no contest to two felony counts of insurance fraud. Williams illegally worked multiple jobs while collecting tens of thousands in workers’ compensation benefits from different insurers. 

Workers’ Compensation is a form of insurance intended to provide compensation for those who are injured while on-the-job. Those who receive benefits are placed on temporary disability and are granted wages to compensate for the time they cannot work. (It’s not meant for someone who wants to get paid for doing nothing.)

Williams claimed to sustain a work-related injury in 2014 while working as an electrician. He filed with California’s State Compensation Insurance Fund (SCIF) to collect temporary workers’ compensation benefits. He also filed another workers’ compensation claim in May 2015 through Travelers Insurance for a separate work-related injury. (One “injury” is an accident, twice is a pattern.)

The California Department of Insurance launched an investigation, which determined that Williams began to work for another employer in March 2015 while continuing to receive benefits.  (A benefits recipient is not allowed to work for a different employer during the time they are receiving workers’ compensation benefits.) In total, Williams worked at various intervals for three different employers from March 2015 to November 2016. (Sounds like he was raking in the dough.)

Williams continued to receive workers’ compensation benefits from SCIF and Travelers for his previous claims while continuing to work for different employers.  He collected over $85,000 in workers’ compensation from SCIF and Travelers Insurance, which he was not entitled to receive.  (These are funds that should have gone to people with legitimate injuries.)

Prosecutors claim that Williams misrepresented the extent of his injuries and employment status to medical providers so he could receive benefits from SCIF and Travelers Insurance. They state that he continued to make false statements to his Qualified Medical Examiner so he could receive permanent disability payments after his temporary benefits ended. (This is the adult equivalent of faking being sick to get out of going to school.)

Williams was sentenced to 60 days in county jail and three years of formal probation. (I’ve had trial subscriptions that last longer than 60 days. It doesn’t seem like a big enough punishment.)  He was also ordered to pay restitution to the SCIF in the amount of $40,000 as well as additional restitution to Travelers Insurance and his former employers.

Unrelated to his workers’ compensation fraud, Williams has been recently charged with grand theft for allegedly stealing his employer’s credit card. (Maybe Williams decided it was time to branch out into other types of crime.) He allegedly used this credit card to pay for an engagement ring and other personal expenses. (What a lucky fiancé.) Keep in mind that the grand theft charges against him are merely allegations and he is to be presumed innocent until proven guilty in a court of law.

If you suspect someone of committing Workers’ Compensation Fraud you can report it to the Office of Inspector General’s online complaint form.

Today’s Fraud of the Day comes from an article, “California Electrician Sentenced for Defrauding Workers’ Comp Providers, Employers,” published by Insurance Journal on October 22, 2020.

Michael Ray Williams, 37, of Daly City, Calif., was sentenced to 60 days in county jail and three years formal probation after pleading no contest to two felony counts of insurance fraud after illegally working for multiple employers while simultaneously collecting over $85,000 in workers’ compensation benefits from two different insurers.

Williams repaid the State Compensation Insurance Fund $40,000 in restitution and was ordered to pay additional restitution to Travelers Insurance and his former employer.

 

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.