Helpful Articles

February, 2007

Workers’ comp fraud prevention; detection and prosecution are a top priority with IWIF. Staying vigilant and Fighting Fraud on All Fronts helps keep premium costs down for our policyholders. Here are just a few of our recent fraud beat wins.

Slammer time

A Baltimore Circuit Court judge found an IWIF claimant guilty of insurance fraud and theft against IWIF. The court sentenced the claimant to six months in jail to be served in the Baltimore City Detention Center. The court also barred him from collecting additional claim benefits from IWIF pertaining to his alleged injury.

The claimant reported to IWIF an alleged work-related injury to his arm while working as a laborer for a Baltimore-based fence company. He claimed he fell on a nail, punctured his arm and could not work as a result of his injury.

The claim became suspect when the claimant’s disgruntled girlfriend contacted IWIF and alleged she had stabbed the claimant in the arm with a knife during a domestic dispute and that he had not fallen on a nail at work. The claimant’s 69-day claim tallied approximately $2,300 in medical expenses and $1,700 in temporary total benefits.

Go directly to jail

A Maryland man was recently sentenced to 12 months in Baltimore County Detention Center with nine months of the sentence suspended and 18 months’ supervised probation after he was found guilty in Baltimore County District Court of false workers’ compensation claim and attempted theft against IWIF.

The defendant allegedly suffered a whiplash injury while he was in a company work truck. While he was being treated for his injury, he collected $1,605 in temporary total disability benefits from IWIF.

IWIF’s Special Investigations Unit began investigating the claimant after the assigned claims adjuster suspected the dates on one of the disability slips had been altered. The medical provider treating the injured worker confirmed the claimant had indeed changed the dates

Paid $12,600 in restitution

A joint investigation by IWIF and the office of the State’s Attorney for Anne Arundel County resulted in a fraud victory for IWIF. A 36-year-old claimant pleaded guilty to felony theft against IWIF in Anne Arundel County Circuit Court. The Baltimore resident received a 60-day suspended sentence, an order to pay $12,600 in restitution to IWIF and placed on 36 months’ supervised probation.

The claimant allegedly suffered a back, hip and foot injury. IWIF paid the injured worker $72,296.59 in temporary total disability benefits and provided vocational rehabilitation benefits whereby he was retrained as a software/web designer.

The investigation found the claimant had been gainfully employed as a web designer and as an assistant varsity wrestling coach for a high school while collecting benefits from IWIF. IWIF’s Special Investigations Unit videotaped the claimant engaged in activities associated with coaching as well as playing full contact men’s lacrosse. {Video file linked here}

Fraud Fighting Scorecard 2006
IWIF’s Special Investigations Unit clamps down on fraud. Check out these year-end numbers for 2005 and 2006.
  2005 2006
Claimant arrests/prosecution referrals: 33 33
Hard dollar cash claim recoveries: $126,000 $195,400
Soft dollar claim reserves takedowns: $28,900,000 $39,607,351
Premium fraud collected: $4,700,000 $5,448,904
To report suspected fraud against IWIF,
please call our



or contact us by e-mail at reportfraud@iwif.com.