Thruway Worker Charged with Fraud after Installing Pools

Installing swimming pools over the summer got a Thruway worker on disability in hot water.

The State Inspector General said the individual is charged with defrauding the Workers’ Compensation system by collecting more than $5,000 in insurance benefits.

The individual had been receiving Workers’ Compensation benefits since allegedly suffering a debilitating injury in May while moving a Thruway guardrail, Scott said. But from June through August, he was seen installing and servicing swimming pools while claiming a disability made him unable to return to work at the Thruway, the IG alleged. During that time he collected $491.68 a week in benefits.

The individual was arraigned in Cambria Town Court on three felonies: third-degree grand larceny, first-degree offering a false instrument for filing and fraudulent practices. He is to return for another appearance Feb. 6.

Source – The Buffalo News

Aroostook County Man Guilty of Workers’ Comp Fraud

AUGUSTA – An Aroostook County trial jury today convicted an individual of theft of more than $10,000 in workers’ compensation benefits.

The individual received over $45,000 in benefits from the Maine Employers Mutual Insurance Company (MEMIC) from July 2009 through February 2012 by claiming that he could not work due to an injury to his hand sustained in 2006 while working at Brewer’s Service Station in Mars Hill. In fact, in January, 2009, he opened his own small engine repair business, Littleton Service, in Littleton, Maine. The Evidence showed that he was performing many physical tasks in connection with his business that were inconsistent with his testimony before the Workers’ Compensation Board.

The State Attorney General commented, “My Office will continue to work with other state agencies to pursue those who would cheat and steal, no matter who or where they are or what they do for work. In these difficult times, all Mainers must pay their fair share.”

Class B theft is punishable by up to 10 years in jail and a fine of $20,000. The case has been continued for sentencing at a future date. An Assistant Attorney General prosecuted the case against the individual for the Attorney General’s Office.

Source – Bangor Daily News

$400,000 Saved!

Capital Investigating saved over $400,000 dollars in medical claims over disability for company!

“I was just looking over the multiple days and hours put into this claim and wanted to let you know that whoever the investigator is, he has done an awesome job. This is potentially damaging claim with exposure of over $500K in which we are able to settle for $100K and all of the video obtained of the claimant’s inconsistency with his disability was used in settlement negations.”

Saving our clients time and money.

The claimant has been ordered to perform two hundred hours of community services and the client will received $2,279.40 in restitution and an apology letter from the defendant. Your cooperation and assistance in this matter is greatly appreciated.

“I am writing to inform you that the claimant pled guilty on Monday to one count of Theft by Deception, a Class A Felony. He was sentenced to six months in the House of Corrections, suspended for three years and ordered to pay a fine of $4,000, which was also suspended for three years. In addition, the claimant has been ordered to perform two hundred hours of community services and the client will received $2,279.40 in restitution and an apology letter from the defendant. Your cooperation and assistance in this matter is greatly appreciated.”

Saving a Buck!

You guys did great work on this case! Thanks again for your efforts.”

“I got a call today from the Attorney regarding the claimant. He was extremely satisfied with our hard work and dedication to this file. Faced with the threat of the excellent videotape evidence obtained by the investigator of the claimant hunting, along with evidence obtained by the NH Fish and Wildlife Division indicating the claimant tagged a buck and a bear in 2007, the claimant and his attorney settled the claim last minute for ½ of the original monetary request!!! Total savings to client $90,000.”