The Monterey County District Attorney’s Office Workers’ Compensation Fraud Unit includes a prosecutor who vertically prosecutes all workers’ compensation fraud cases from filing through sentencing. The unit has two dedicated investigators who provide additional investigation for cases that are submitted from an insurance company and also investigate cases from inception. Additionally, the unit works closely with investigators from the California Department of Insurance, Morgan Hill office.
Our unit has an aggressive campaign to identify, investigate and prosecute any unscrupulous doctors, lawyers, employers and applicants who have filed fraudulent claims. The unit also investigates and prosecutes any employers who unlawfully deny an injured worker their entitled benefits.
The unit has a program that targets employers who fail to obtain insurance for their employees or who fraudulently obtain insurance at less than the proper rate.
Workers' Compensation Fraud is a crime. There are many types of fraud within the workers' compensation system:
Uninsured Employers: Failing to have workers’ compensation insurance coverage for their employees when required by law.
Applicant Fraud: An employee who lies to receive benefits.
Employer Fraud: Employers that wrongfully deny an injured worker their entitled benefits or discourage an injured worker from pursuing a claim.
Premium Fraud: Employers who lie to reduce their insurance premium.
Provider Fraud: Medical providers who commit fraud in connection with workers’ compensation.
If you have information regarding any form of Workers’ Compensation Insurance Fraud please report it to the Department of Insurance, Morgan Hill Office or to the Monterey County District Attorney’s Office, Workers’ Compensation Unit. The more information you provide allows our unit to follow-up on these reported suspected activities.
As an employer, if you think someone is committing workers’ compensation fraud, report it to your workers’ compensation insurer. Every workers’ compensation insurer is required to have a Special Investigation Unit to handle these cases. Self-insured employers can report the fraud to their Third Party Administrator.
As an employee, if you have information your employer does not carry workers’ compensation insurance, you can report this directly to the Department of Insurance, Morgan Hill Office or to the Office of the District Attorney, Workers’ Compensation Unit.
If you are an injured worker who has been injured and your employer has discouraged you from pursuing a claim, you can report this directly to the Department of Insurance, Morgan Hill Office or to the Office of the District Attorney Workers’ Compensation Unit.