| ROSEVILLE, Calif., June 14 /PRNewswire/ -- IHI Insurance Services announced another fraud conviction in a workers' compensation claim resulting in $12,224 in restitution, 90 days in jail, and three years of formal probation. This award followed the guilty plea of a workers' compensation claimant on one count of insurance fraud, in violation of Insurance Code 1871.4(a) (1), for making false or fraudulent written or oral statements.
Since 1994, IHI and its workers' compensation division, Intercare Insurance Services, have been leaders in proactive claims administration, medical case management expertise, state-of-the-art information systems, and innovative early notification process that act in concert to significantly reduce the total cost of a claim. As part of this commitment to reduce claims -- which ultimately lowers workers' compensation costs to clients -- IHI developed an in-house Special Investigation Unit (SIU), to control the incidence of fraud, employing diligent investigation efforts and reporting.
IHI Insurance Services, adjusting a workers' compensation claim on behalf of the California Insurance Guarantee Association, played a critical role in the Santa Barbara County District Attorney's investigation and plea bargain by Santa Barbara resident Leopoldo Navarro, 39, a former employee of McConnell's Fine Ice Cream.
Navarro, who pleaded guilty to insurance fraud, had alleged that he was disabled from work at McConnell Fine Ice Cream while at the same time working for another employer.
"IHI is committed to investigating and fighting all types of insurance fraud in the State of California," said Kevin Hamm, CEO of IHI Insurance Services and its Intercare division. "Workers' comp fraud is a plague on the businesses in California. It drives up rates, harms employees with legitimate claims and further erodes a California's workers' comp industry already in crisis. We protect our clients at every turn and go after insurance fraud with tenacity."
IHI's Special Investigation Unit investigates all types of workers' compensation insurance fraud and has an excellent track record in the prosecution of workers' compensation fraud. Over 80% of the claims submitted to District Attorney Offices by Intercare have resulted in the filing of criminal complaints. IHI and Intercare sent 15 cases to district attorneys throughout California in 2003.
"We have a dynamic Special Investigation Unit," added Bill Warner, who manages the investigations unit for IHI. "We work in cooperation with local law enforcement officials and protect our clients and their employees, as well as the integrity of the workers' compensation insurance system by fighting insurance fraud."
About IHI Insurance Services
IHI Insurance Services is rapidly becoming a leader in commercial insurance through intelligent solutions and client-focused approach for workers' compensation claims management, alternative risk transfer programs, employee benefits and consulting, property & casualty and consulting, and cost containment programs. These services are provided through the integrated talents and capabilities of its subsidiary companies -- VIIA, InterMed and Intercare -- allowing clients to gain control over insurance programs and costs in an era of runaway premiums and confusing products. The company, headquartered in Roseville, California, has nearly $50 million in annual revenue with more than 425 employees in eight offices throughout California. For more information, visit http://www.intercareins.com/.
About CIGA
Created by the California Legislature in 1969, the California Insurance Guarantee Association (CIGA) is an organization responsible for adjusting the claims of insolvent insurance carriers licensed to conduct business in the State of California. CIGA's current obligations include several thousand claims handled by staff personal and third party administrators. For more information, please visit: http://www.caiga.org/.
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