Workers’ Compensation Fraud

When it comes to worker’s compensation insurance, you can get in trouble for two reasons.

First, you can be charged with fraud for not getting workers’ compensation when it is required. This crime is often called “failure to secure workers’ compensation insurance” under Section 440.105(4)(a)(3).

Detectives with the Economic Crimes Unit or the Florida Department of Financial Services will conduct elaborate sting operations to set up unsuspecting workers and employers.

In fact, 35 suspects were recently arrested in Pinellas County, FL, during a two-day sting operation for unlicensed contracting and the failure to secure workers’ compensation. Similar sting operations recently took place in Hillsborough County, Pasco County, and Polk County, FL.

Second, you can be charged with fraud for making a false claim. While defending a claim for workers’ compensation, your employer or their attorney might report or refer allegations of fraud to law enforcement detectives. In Florida, those claims of workers’ compensation fraud are investigated by Florida’s Division of Insurance Fraud.

Each year hundreds of individuals are arrested for allegations of fraud in workers’ compensation claims throughout the Tampa Bay area. No matter how the investigation begins, you need an experienced attorney to help you fight the charges.

Attorneys for Workers’ Compensation Fraud in Tampa, FL

If you find out that you are being investigated by any law enforcement detective with the Division of Insurance Fraud or the Florida Department of Financial Services, then immediately speak with an experienced criminal defense attorney to discuss your rights and what you need to do right now to protect yourself against the allegations.

Our best advice is to NEVER make any false statement in a workers’ compensation case. These cases are prosecuted aggressively, and the attorneys defending the workers’ compensation claim use tremendous resources to look for fraud.

In fact, private investigators are often hired to follow you and videotape your every move in insurance fraud cases.

If you are under investigation, contact an experienced criminal defense attorney with the Sammis Law Firm to discuss any workers’ compensation fraud case in the Tampa Bay area including Tampa in Hillsborough County, Bartow or Lakeland in Polk County, Brooksville in Hernando County, New Port Richey or Dade City in Pasco, or Bradenton in Manatee County, Florida.

We also represent clients accused of unlicensed contracting crimes and related charges for grand theft and scheme to defraud.

Call 813-250-0500.

Never Speak to Law Enforcement About Workers’ Comp Fraud

Even if you are completely innocent of any criminal conduct, anything you say to law enforcement can and will be used against you. Most criminal defense attorneys agree that it is NEVER in your best interest to speak with law enforcement about criminal allegations until AFTER you have retained an attorney.

A criminal defense attorney is often in the best position to present your side of the story to law enforcement to convince them that a criminal prosecution is not warranted.

Call an experienced white collar crime defense attorney at the Sammis Law Firm to discuss any workers’ comp claim fraud investigation or prosecution in the Tampa Bay area including Tampa in Hillsborough County, Bartow, and Lakeland in Polk County, New Port Richey and Dade City in Pasco County, St. Petersburg and Clearwater in Pinellas County, FL.

Examples of Workers’ Compensation Fraud Crimes

The most commonly prosecuted crimes for workers’ compensation in Florida include:

  • 4401E – 440.105(4)(A)3 AND (F) – FAIL TO SECURE WORKER’S COMPENSATION INSURANCE (employer)
  • 4401D – 440.105(4)(B)5 AND (F) – WORKER COMPENSATION FRAUD (Premium Fraud)
  • 4401C – 440.105(4)(A)1 AND (F) – WORKERS’ COMPENSATION FRAUDULENT STATEMENT (employer)
  • 4401B – 440.105(4)(B) – WORKER’S COMPENSATION FRAUD

Workers’ Compensation Premium Fraud in Florida

The Florida Department of Financial Services has identified workers’ compensation premium fraud by Money Service Businesses in Florida as the largest threat to the workers’ compensation market in Florida. This premium fraud results in claims for which premiums were never collected.

Florida’s DIF Investigative Task Force was created in response to investigate money service business facilitated workers’ compensation fraud.

Money Service Business-Facilitated Workers’ Compensation Fraud

Money Service Business-Facilitated Workers’ Compensation Fraud in Florida is often discovered when officials with the Division of Workers’ Compensation or the Bureau of Compliance discover workers on job sites who are not reported as employees on any workers’ compensation policy.

Instead, the crew “rents” a certificate of a “shell” company that was set up to avoid the workers’ compensation requirements.

Some of these individuals who use the shell company scheme also use undocumented foreign national laborers in order to avoid paying workers’ compensation insurance premiums. The insurance certificates of the shell company are being used by dozens of crew leaders all around the State of Florida.

Each crew claims to work for the shell company but is really just “renting” the insurance certificates. In the last few years, prosecutions for these types of schemes have skyrocketed. Prosecutions often include state racketeering charges based on the predicate offenses of:

  • Working without Worker’s Compensation Coverage (a third-degree felony);
  • Perjury in official proceedings during a workers’ compensation fraud investigation (a third-degree felony);
  • Providing false or misleading statements in a workers’ compensation fraud investigation;
  • Presenting false identity information for employment or workers’ compensation claim;
  • Presenting a fraudulent certificate charged as uttering forgery instruments;
  • Using false proof of compliance with Florida’s insurance requirements under Florida Statute Section 440 (a third-degree felony);
  • Falsifications of third-party business-to-business checks;
  • Collecting facilitator fees; and
  • Presenting fraudulent documents that are violations of FS 560 which regulates Money Service Businesses in Florida.

Instead of workers’ compensation claims, injured seamen and longshoremen in the maritime industry bring claims for injuries under the Jones Act or the Longshore and Harbor Workers’ Comp Act.

Bureau of Workers’ Compensation Fraud – Tampa Division

Tampa’s Division of the Bureau of Workers’ Compensation Fraud is headed by Lieutenant Doreen Rivera Rapp. Statistics show that Lt. Rapp’s Tampa division lead the Bureau in the number of arrests which totaled 63 arrests in the fiscal year 2010-2011.

Bureau of Workers’ Compensation Fraud – Tampa Division
8600 Hidden River Parkway, Suite 100
Tampa, FL 33637
(813) 972-8602

Florida’s Bureau of Workers’ Compensation Fraud (BWCF) investigates criminal violations of Florida’s Workers’ Compensation laws. The BWCF includes four (4) supervisors assigned to dedicated squads located in Tampa, Orlando, Miami, and West Palm Beach, along with 21 detectives working throughout the state.

These detectives work with six (6) squads in the Bureau of Insurance Fraud to investigate workers’ compensation fraud cases in their areas including St. Petersburg, Fort Lauderdale, Fort Myers, Jacksonville, Tallahassee, and Pensacola.

Other charges investigated include unlicensed contractors, employees working other jobs while receiving workers’ compensation benefits, employees who file false on-the-job injuries or exaggerate their injuries, and businesses employing workers without appropriate workers’ compensation coverage.

For the Fiscal Year of 2017/2018, the efforts of the BWCF resulted in 335 successful prosecutions with more than 398 arrests and 502 cases presented for prosecution.

Finding an Attorney for Worker’s Compensation Claim Fraud

Once you discover that you are being investigated for Workers’ Compensation Claim Fraud then contact an experienced criminal defense attorney at the Sammis Law Firm before you make any statements to law enforcement.

We work with our clients to protect their rights and gather favorable evidence.

Our insurance fraud defense attorneys negotiate with the law enforcement detectives investigating the claims and the prosecutors with the State Attorney’s Office who decide whether to formally file criminal charges.

We aggressively fight claims of white collar and financial crime.

Contact us to discuss your case today.

Call (813) 250-0500.

This article was last updated on Friday, May 21, 2021.