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State Fund Today

How Fraud Hurts Everyone

State Fund
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Fraud not only hurts the workers’ compensation carriers that provide coverage to the thousands of businesses in California, but it also hurts those businesses in the form of higher rates for the premiums they pay for their coverage.

Together with our Special Investigation Unit, we’re doing everything we can to prevent fraud and work with other agencies to prosecute cases. Fighting fraud and presenting anti-fraud trainings are important parts of our corporate strategy as a strong, stable provider of workers’ compensation insurance in California. We are a watchdog of the marketplace and as such, we have a responsibility to price coverage fairly, to deliver superior outcomes for injured employees and the employers we serve by providing consistent and quality work in paying what we owe, defending what we don’t, and doing it with a great sense of urgency.

According to Jay Bobrowsky, Senior Vice President of SIU at State Fund, “It’s a team effort that starts with new employee orientation, when we have a chance to tell our new employees the different types of fraud that we see and how to address it. We work with many internal departments such as the Underwriting, Legal, Audit, and Credit & Collections units within State Fund to address fraud and take the necessary steps to prevent it.”

Recently, we determined that a company that offers interpreter services committed provider fraud. Our investigation revealed the company double billed by billing for services not rendered and billing for interpreting services while using uncertified interpreters. The company ended up settling for a lump sum payment of $175,000 and an agreement to write off all liens and pending bills and not bill State Fund in the future. The dismissal and waiver for all pending bills and liens had an estimated total value of $22,250,886.

Jay encourages all brokers to reach out to our SIU Team if they suspect fraud by sending an email to SIUMailbox@scif.com or by calling (888) 782-8338.

Together we all can take the necessary steps to prevent fraud and keep California working!