News roundup: Cavalcade of Risk, massive fraud scheme, investigator deaths, premium hardening & more

June 15th, 2011 by Julie Ferguson

Cavalcade of Risk – for the biweekly smorgasbord of risk-related news from the blogosphere, check out the new edition of Cavalcade of Risk hosted at Political Calculations.
The $17 million fraud – not chump change – Most employers and insurers get very heated on the topic of work comp fraud – as well they should. But while keeping an eye on the front door for shoplifting, some thieves are loading up the company safe from the back door. This week, four members of a California doctor mill were indicted in a $17 million workers’ comp fraud. This stunning scheme bilked the city of Los Angeles and 19 insurance companies. Joe Wheeler talks more about the fraud and how it exposes a weakness in the system. He rightly notes, “That this relatively small fraud provider ring offering obscure medical procedures could make off with millions of dollars before being caught should make anyone involved in workers’ comp benefits take a breath.” Note to employers: it’s not enough to think your insurer will manage everything – you need to take an active interest in managing and questioning claims, too.
In the line of duty – Louisiana flags are flying at half mast this week for two insurance investigators who were shot to death by an agent last week while investigating fraud. According to Insurance Times, investigators Kim Sledge and Rhett Jeansonne “…had gone to the Ville Platte office of suspended insurance agent John Melvin Lavergne to collect records. Lavergne shot the investigators and then killed himself.” Louisiana is now looking into whether fraud investigators should be able to carry guns.
Is the soft market finally hardening? – Joe Paduda talks about recent reports from Towers Perrin and Fitch Ratings pointing to firming work comp premiums. No, really!
Dollars for doctors – ProPublica has been featuring an ongoing series that investigates the financial ties between the medical community and the drug and device industry. You can follow the entire series from the above link. In addition to several feature stories, there were frequent updates in made in May, several of which discuss drug industry ties to medical societies. In October, ProPublica also rolled out a searchable database of physicians who have received drug money, gleaned from public disclosures of seven large pharma companies. For a sampling, here is Massachusetts.
Ferreting out the more obscure news… – Among all the informative and useful information he posts over at Comp Time, Roberto Ceniceros also manages to ferret out some of the quirkier workers comp stories. This week, he posted about Palin’s emails and the workers comp connection and last week, it was porn industry hazmat suits.
Confined space videosWorkSafeBC produces a lot of great safety resources. Recently, a three-part video series on confined space came to our attention – worth checking them out. Part 1: Safe Yesterday, Deadly Today; Part 2: Test to Live; and Part 3: Rescue: Just Calling 911 Doesn’t Cut It.

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