What is Workers' Compensation Fraud in Illinois?

From the Illinois Workers' Compensation Commission website - Fraud Unit...

Read what constitutes fraud and the associated penalties in the Illinois Workers' Compensation Act - 

     Section 25.5.  Unlawful acts; penalties.

Read the list of Convictions Resulting from Workers' Compensation Fraud Unit Investigations in 2008 & 2009 - 

    WCFU Convictions


Workers' Compensation Fraud is a Crime -  Posters.

It is illegal for anyone—a worker, employer, insurance carrier, medical provider, etc.—to intentionally do any of the following:

• Make a false claim for any w.c. benefit;

• Make a false statement in order to obtain or deny benefits;

• Make a false statement in order to prevent someone from filing a legitimate claim;

• Make a false certificate of insurance as proof of insurance;

• Make a false statement in order to obtain w.c. insurance at less than the proper rate;

• Make a false statement in order to obtain approval to self-insure or reduce the security required to self-insure;

• Make a false statement to the state’s fraud and noncompliance investigation staff in the course of an investigation;

• Help someone commit any of the crimes listed above;

• Move, destroy, or conceal assets so as to avoid payment of a claim.

A “statement” includes any writing, notice, proof of injury, or any medical bill, record, report, or test result. 

Anyone found guilty of any of these actions is guilty of a Class 4 felony, punishable by 1-3 years imprisonment and a $25,000 fine.
The guilty party shall be required to pay complete restitution, and may be found civilly liable for up to three times
the value of benefits or insurance coverage that was wrongfully attained.

 

Contact information
You must submit complaints in writing.  You must identify yourself and, at some point, the person you are reporting will be given your name.
You must provide a written complaint, provide enough information to cause the unit to open an investigation, and be prepared to testify. 
Anyone who intentionally makes a false report is guilty of a Class A misdemeanor, punishable by up to 12 months imprisonment and a $2,500 fine.


Northern Illinois

Adam Monreal
Workers' Compensation Fraud Unit
Illinois Department of Insurance
adam.monreal@illinois.gov
312/814-1323
toll-free 877/923-8648
100 W. Randolph St. 9th floor
Chicago, IL 60601

Downstate

Francis "Buzz" Walsh
Workers' Compensation Fraud Unit
Illinois Department of Insurance

francis.walsh@illinois.gov
312/636-9457
toll-free 877/923-8648
320 W. Washington
Springfield, IL  62786


 

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