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 Carlos
Cruz, a painter employed by Maryland Management, was recently found
guilty of felony theft over $500 against the Injured Workers' Insurance
Fund in Montgomery County District Court.
Judge C. J. Vaughey sentenced Cruz to 18 months incarceration, suspended; 18 months of supervised probation; and ordered him to pay IWIF restitution in the amount of $1,192.71. In addition, Cruz was ordered to pay a $500 fine and $50 court fees. Cruz alleged he injured his right knee while working for Maryland Management. He collected temporary total disability benefits from IWIF from January 2002 to April 2002 and again in November 2002 through June 2003. An official from the management company alerted IWIF's Special Investigations Unit to possible claimant fraud due to suspicious circumstances surrounding the claimant's alleged injury. IWIF's investigation revealed Cruz was collecting benefits from IWIF while he was employed as a carpenter for a construction company located in Middle River, MD from May to June 2003.  In
another recent case, a routine premium audit performed on a current
IWIF policyholder uncovered a fraudulent certificate of insurance
submitted by a former IWIF policyholder. On September 2004, Dave R.
Rajeshkumar, trading as R. Rajesh Home Improvement, presented a false
IWIF certificate of insurance to Michaelson, Connor and Boul, a housing
management firm and IWIF policyholder. Upon verification, the IWIF
auditor discovered the certificate had been altered to reflect Rajeshkumar
had workers' compensation insurance coverage from June 10, 2004 to
June 10, 2005. The case was then assigned to IWIF's Special Investigations
Unit. IWIF records show Rajeshkumar had canceled his coverage on June
10, 2003.
During the investigation, Rajeshkumar denied changing the dates on his certificate, then recanted his statement. Later, he told IWIF he thought his policy would automatically reinstate itself if he simply changed the dates on his old certificate of insurance. Rajeshkumar pleaded guilty to an agreed statement of facts in Baltimore City District Court. Judge Timothy Doory sentenced Rajeshkumar to 18 months of unsupervised probation and ordered him to pay $57 in court costs.  Baltimore
City resident Larry Anders, Sr. pleaded guilty to false claim against
IWIF after a company investigation revealed Anders had falsified disability
slips and submitted them to IWIF in an attempt to obtain temporary
total benefits during a period in which he was never treated by a
medical professional. During the investigation, the claimant's wife
called IWIF's Special Investigations Unit and admitted to the fraud
investigator that her husband created the phony disability slips.
IWIF charged Anders with forgery, false claim, and theft. In a plea agreement, Judge L. Yvonne Holt-Stone of Baltimore City District Court sentenced Anders to one year of supervised probation and ordered him to pay $600 in restitution to IWIF. Fraud Fighting Scorecard YTD IWIF's Special Investigations Unit clamps down on fraud. Check out these year-to-date numbers for 2005: Claimant arrests/prosecution referrals: 17 To report suspected fraud against IWIF, |
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