Guilty Plea In Employer Workers’ Comp Fraud Case
A Lakeland construction company owner faces up to twenty years in federal prison after he admitted to multiple workers’ compensation fraud counts.
According to court documents, the 52-year-old man had agreements with contractors and subcontractors to use workers employed by him at construction sites and these workers were often undocumented immigrants who were actually working for and under the daily supervision and direction of the contractors.
As a result, the employees of the company performed work on job sites without adequate insurance coverage, said investigators. In addition, the insurers lost premiums they would have charged had they been aware of the true number of workers their policies were being manipulated to cover.
Employer Job Injury Fraud
Workers’ compensation insurance premiums have dropped significantly in Florida in recent years. But some employers want more. So, they either circumvent or ignore the mandatory workers’ compensation insurance purchase requirement in the Sunshine State.
False statements on insurance forms, like the ones in the above story, are very common. These false statements usually involve misclassification.
The law only requires employers to buy coverage for employees. Therefore, to reduce their risk and their premiums, many bosses intentionally misclassify employees as independent contractors.
This tactic doesn’t work. Insurance companies have a very broad definition of “employee.” When they discover these false statements, they usually deny payment.
Job category misclassification is common as well. If a roofing company has twenty roofers and ten secretaries, the owner might claim the company has twenty secretaries and ten roofers. Roofers are high-risk employees who are expensive to insure.
On a related note, many employers understate payroll size. Since workers’ compensation replaces lost wages, employee income is a key risk element.
At the outset, insurance companies often don’t ask too many questions. The insurance company is more than happy to take the company’s money. Inspectors only detect this fraud when the insured party files a claim. Then, adjusters look for ways to deny that claim.
Many companies don’t even bother to put up a front. They simply ignore the requirement. If workers get hurt, they offer to pay benefits under the table. Even if the employer follows through on this promise, which is a big “if.” workers suffer. Less money in the system means a Tampa workers’ compensation lawyer has a hard time obtaining fair compensation for coworkers. Furthermore, since the injury never comes to light, the employer does nothing to improve safety.
Usually, employers cannot use some “silver bullet” defenses when fraud-related cases go to court. Therefore, it’s easier for a Tampa workers’ compensation lawyer to prove negligence, or a lack of care, by a preponderance of the evidence, or more likely than not.
This evidence usually starts with medical bills and witness statements. Such proof is usually sufficient to make a bare-bones case. Usually, minimum effort yields minimum results, and that’s usually true in this context.
So, to supplement this proof and obtain maximum compensation, victim/plaintiffs often use medical and other experts. These individuals testify that the victim’s medical bills were reasonably necessary, and they also testify about the everyday effects of a job-related injury.
In some cases, an attorney can bypass the workers’ compensation system and file a negligence claim. However, these claims are risky, since a full range of defenses is usually available.
These defenses include comparative fault. For example, if a lifeguard slips and falls on a wet spot, the insurance company could argue that the victim should have seen the water on the ground and should have avoided it.
Victims may also file defective products claims against manufacturers. These companies cannot hide behind state workers’ compensation laws and avoid taking responsibility for the injuries their defective products cause.
Work With a Tough-Minded Hillsborough County Attorney
Injury victims are entitled to important financial benefits. For a free consultation with an experienced job injury lawyer in Tampa, contact Kobal Law. After hours, virtual, home, and hospital visits are available.