ROSEVILLE, Calif., June 14, 2004 – LAWFUEL – IHI Insurance Services
announced another fraud conviction in a workers’ compensation claim resulting
in $12,224 in restitution, 90 days in jail, and three years of formal
probation. This award followed the guilty plea of a workers’ compensation
claimant on one count of insurance fraud, in violation of Insurance Code
1871.4(a) (1), for making false or fraudulent written or oral statements.
Since 1994, IHI and its workers’ compensation division, Intercare
Insurance Services, have been leaders in proactive claims administration,
medical case management expertise, state-of-the-art information systems, and
innovative early notification process that act in concert to significantly
reduce the total cost of a claim. As part of this commitment to reduce claims
— which ultimately lowers workers’ compensation costs to clients — IHI
developed an in-house Special Investigation Unit (SIU), to control the
incidence of fraud, employing diligent investigation efforts and reporting.
IHI Insurance Services, adjusting a workers’ compensation claim on behalf
of the California Insurance Guarantee Association, played a critical role in
the Santa Barbara County District Attorney’s investigation and plea bargain by
Santa Barbara resident Leopoldo Navarro, 39, a former employee of McConnell’s
Fine Ice Cream.
Navarro, who pleaded guilty to insurance fraud, had alleged that he was
disabled from work at McConnell Fine Ice Cream while at the same time working
for another employer.
“IHI is committed to investigating and fighting all types of insurance
fraud in the State of California,” said Kevin Hamm, CEO of IHI Insurance
Services and its Intercare division. “Workers’ comp fraud is a plague on the
businesses in California. It drives up rates, harms employees with legitimate
claims and further erodes a California’s workers’ comp industry already in
crisis. We protect our clients at every turn and go after insurance fraud with
tenacity.”
IHI’s Special Investigation Unit investigates all types of workers’
compensation insurance fraud and has an excellent track record in the
prosecution of workers’ compensation fraud. Over 80% of the claims submitted
to District Attorney Offices by Intercare have resulted in the filing of
criminal complaints. IHI and Intercare sent 15 cases to district attorneys
throughout California in 2003.
“We have a dynamic Special Investigation Unit,” added Bill Warner, who
manages the investigations unit for IHI. “We work in cooperation with local
law enforcement officials and protect our clients and their employees, as well
as the integrity of the workers’ compensation insurance system by fighting
insurance fraud.”
About IHI Insurance Services
IHI Insurance Services is rapidly becoming a leader in commercial
insurance through intelligent solutions and client-focused approach for
workers’ compensation claims management, alternative risk transfer programs,
employee benefits and consulting, property & casualty and consulting, and cost
containment programs. These services are provided through the integrated
talents and capabilities of its subsidiary companies — VIIA, InterMed and
Intercare — allowing clients to gain control over insurance programs and
costs in an era of runaway premiums and confusing products. The company,
headquartered in Roseville, California, has nearly $50 million in annual
revenue with more than 425 employees in eight offices throughout California.
For more information, visit http://www.intercareins.com.
