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13 indicted in multimillion-dollar comp claim fraud scheme



Health Care Benefits Regulation Workers Comp Coverage General liability More + Less -

The San Diego District Attorney's office says 13 people have been indicted in what it calls “one of the largest workers' compensation health care insurance bribery schemes ever uncovered in San Diego County.”

The alleged scheme included “millions of dollars” in fraudulent workers comp claims, the attorney's office said in a statement Thursday. Victims included Broadspire Services Inc., Gallagher Bassett Services Inc., Hartford Financial Services Group Inc., Liberty Mutual Insurance Co., Sedgwick Claims Management Services Inc. and Zurich Insurance Group Ltd.

The San Diego attorney's office has accused several health care providers and attorneys of referring injured workers to each other in exchange for kickbacks paid to owners and operators of chiropractic clinics in San Diego, Escondido, California and Calexico, California. Defendants in the case are accused of paying $450,000 in kickbacks connected with “millions of dollars” in false comp claims.

“Getting paid kickbacks to refer patients for medical services is illegal,” the statement reads. “It creates an underground market where patients are bought and sold. Kickbacks also drive up the cost of workers comp insurance for law-abiding businesses.”

Eight of the defendants in the San Diego case were indicted in November by the U.S. Attorney's Office in relation to similar kickback accusations.