Insurance Fraud Unit

WORKERS' COMPENSATION INSURANCE FRAUD

The Workers' Compensation Insurance system is a valuable program designed to protect and compensate workers for injuries and illnesses occurring in the workplace. Benefits can include medical treatment, disability payments, job displacement benefits, and death benefits.  All employers are required to have workers’ compensation insurance.

Workers’ Compensation Insurance Fraud negatively impacts industries, employees and employers, the medical profession, and local business within Sonoma County and throughout the state.

THERE ARE TWO MAIN TYPES OF WORKERS' COMPENSATION INSURANCE FRAUD:

• Premium Fraud occurs when an employer does not have a workers’ compensation insurance policy, or an employer misrepresents the number and/or type of employees; and
• Claimant Fraud occurs when a worker makes a fraudulent work injury claim, which can include exaggerating the extent or severity of an injury, working while collecting disability payments, or making a claim for a non-work-related injury.

AUTOMOBILE INSURANCE FRAUD

It is illegal to drive in California without insurance.  California law requires drivers to show financial responsibility for their vehicle in case of injury to other people or damage to their property. Automobile Insurance Fraud contributes to rising insurance costs for all Californians. 

AUTOMOBILE INSURANCE FRAUD CAN PRESENT IN MANY WAYS, INCLUDING:

• Claimant Fraud includes lying about when an accident occurred, claiming damage that pre-existed the policy, purchasing insurance after the fact, making false claims for personal injury, and lying about the identity of the driver to obtain coverage for the incident.
• Premium Fraud includes withholding relevant information when purchasing a policy to receive a lower premium. Relevant information includes the disclosure of all drivers of the vehicle and if the vehicle is used for ride share or delivery purposes.