SB 536 Expands Workers’ Comp Fraud Reporting: EDD to Join Enforcement Loop
May 05, 2025 | JacobiJournal.com – Workers comp fraud oversight could soon tighten in California, addressing one of the state’s most persistent cost drivers in the insurance system. On May 5, 2025, lawmakers introduced SB 536, authored by Senator Bob Archuleta (D), to significantly expand fraud reporting requirements and allow greater data-sharing between agencies. The measure seeks to close long-standing enforcement gaps by integrating the Employment Development Department (EDD) into the existing reporting network. Supporters argue that by giving investigators broader access to payroll data—while maintaining strict privacy safeguards—the bill could help uncover fraudulent schemes earlier, prevent premium underreporting, and reduce financial losses that ultimately impact honest employers and employees. EDD Added to Workers Comp Fraud Reporting Network Currently, insurers and licensed rating organizations are required to report suspected fraud to local district attorneys and the Department of Insurance Fraud Division. SB 536 would broaden this reporting chain by adding the Employment Development Department (EDD) as a mandatory recipient of these referrals. The inclusion of EDD is intended to close long-standing enforcement gaps. Payroll fraud, such as underreporting employee wages or misclassifying workers to reduce insurance costs, frequently overlaps with workers comp fraud schemes. By having EDD directly notified of suspected fraud, investigators can cross-reference wage records, employer classifications, and tax data against insurance filings. This coordinated approach could help uncover fraud patterns that might otherwise go undetected when agencies work in isolation. For example, if an employer reports lower payroll figures to an insurer but higher amounts to another agency, that discrepancy could flag potential premium fraud. With EDD in the loop, such inconsistencies can be investigated more quickly, reducing the time it takes to build a prosecutable case. Insurers to Gain Limited Access to Payroll Records For the first time, SB 536 would allow insurers and rating organizations to request payroll data from EDD. This data could help verify suspected premium fraud. However, there are limits. The bill clearly states that personal identifying information must remain confidential. Insurers can only share data with law enforcement when submitting a formal fraud referral. This ensures that investigations are balanced with worker privacy. Improving Investigations While Preserving Rights By giving investigators access to more complete data, SB 536 aims to improve fraud detection. At the same time, it reinforces safeguards to protect workers’ personal information. The bill is set for a hearing in the Senate Appropriations Committee on May 12, 2025. If passed, it could enhance fraud prevention and reduce premium inflation for honest employers. More information available here: Official Document. FAQs: About SB 536 and Workers Comp Fraud Reporting What changes does SB 536 make to workers comp fraud reporting? SB 536 adds the Employment Development Department to the workers comp fraud reporting network, allowing for better detection of overlapping payroll and premium fraud. Why is the EDD’s involvement important in workers comp fraud cases? EDD’s access to payroll data can help identify workers comp fraud more quickly, especially when it overlaps with payroll tax violations. How could SB 536 impact future workers comp fraud investigations? By expanding data sharing and reporting requirements, SB 536 could make workers comp fraud investigations faster and more accurate while protecting worker privacy. Bookmark JacobiJournal.com for expert coverage of legislative developments, fraud enforcement cases, and policy reform that affect California’s workers’ compensation landscape. From court rulings to committee hearings, we keep professionals informed and prepared. 🔎 Read More from JacobiJournal.com:
Court Rejects Carpool Exception to Going-and-Coming Rule, No Liability Found
May 02, 2025 | JacobiJournal.com — Workers compensation commute rule was at the center of a recent California appellate decision involving a disputed carpool exception. On May 2, 2025, JacobiJournal.com reported that the court reaffirmed the long-standing “going-and-coming rule,” holding that an employee injured while carpooling in a privately arranged ride with a co-worker was not entitled to employer liability coverage—even though the co-worker received a small travel stipend from the employer. Background: The Going-and-Coming Rule Under California workers’ compensation and liability law, the workers compensation commute rule—also known as the going-and-coming rule—generally exempts employers from liability for employee injuries or torts that occur during the employee’s commute to and from work. Exceptions to this rule exist, particularly when the commute is considered part of the scope of employment or when the employer receives a direct benefit from providing or arranging transportation. Case Details The case involved an employee who was injured in a car accident while carpooling with a co-worker. The co-worker had coordinated the carpool arrangement informally and received a modest stipend from the employer intended to encourage carpooling and reduce parking congestion. In its analysis, the court reviewed whether this situation could qualify as an exception under the workers compensation commute rule, which determines when an employer can be held liable for commute-related injuries. Ultimately, the court found that the stipend did not transform the co-worker into an agent of the employer, nor did it constitute sufficient employer control to make the carpool trip fall within the course of employment. The ruling emphasized that the workers compensation commute rule continues to exclude most voluntary carpools from coverage, even when small incentives are provided, unless the employer directly mandates or manages the transportation arrangement. Court’s Reasoning Court Rejects Carpool Exception, The panel emphasized that the employer neither mandated the carpool nor exercised control over the transportation. Therefore, the injury sustained during the commute remained outside the scope of employment. The court declined to extend liability under the exception to the going-and-coming rule, noting that doing so would significantly blur the boundary between personal and work-related travel. This decision reaffirms longstanding precedent that voluntary carpools typically do not qualify for exceptions to the going-and-coming rule—even when small employer incentives are involved. Source FAQs: About the Workers Compensation Commute Rule What is the workers compensation commute rule? The workers compensation commute rule limits employer liability for injuries sustained during an employee’s normal commute. Are carpools covered under the workers compensation commute rule? Generally, voluntary carpools are not covered unless they are required or directly controlled by the employer. Why does the workers compensation commute rule matter? It sets clear boundaries between personal travel and work duties, helping define when injuries are work-related. Can employer-provided stipends affect the workers compensation commute rule? In most cases, small employer-provided travel stipends do not override the workers compensation commute rule. Unless the employer exerts significant control over the transportation or makes it a work requirement, commute-related injuries typically remain outside the scope of workers’ compensation coverage. How does the workers compensation commute rule apply to remote or hybrid employees? For remote or hybrid employees, the workers compensation commute rule usually applies only to travel between home and the employer’s physical workplace. Trips made purely for personal reasons are not covered, but if travel is required for a specific work assignment, different rules may apply. Want to stay ahead of legal developments in employment and workers’ compensation? Visit JacobiJournal.com for detailed case law analysis, fraud updates, and court rulings that matter to legal, insurance, and HR professionals. 🔎 Read More from JacobiJournal.com:
Fired State Employees Exposed Personal Data of 33K Texans
May 1, 2025 | JacobiJournal.com – Fired State Employees Exposed Personal Data of 33K Texans: Late Wednesday, the Texas HHSC data breach was confirmed when the Texas Health and Human Services Commission (HHSC) notified 33,529 recipients of state benefits that fired state employees had improperly accessed their private information. This latest announcement follows an ongoing investigation into breaches involving state employees who accessed Medicaid, food stamp, and other assistance programs’ data. Three months ago, the agency notified 61,104 Texans about the breach of their personal information by state employees. Seven employees were fired at that time, including two who had stolen from recipients’ food stamp cards. Texas HHSC Data Breach: State Employees Involved in Unauthorized Access In February, HHSC notified lawmakers that two more employees had been fired, raising the total to nine employees who accessed individuals’ accounts without legitimate reasons. These employees are now responsible for breaching the personal data of another 33,529 account holders who applied for or received assistance between June 2021 and January 2025. HHSC has not yet determined how many of those individuals had their benefits compromised. Fired State Employees Exposed Personal Data of 33K Texans Recommendations for Affected Texans HHSC urges affected individuals to carefully review their accounts and examine statements from health care providers, insurance companies, and financial institutions to ensure that their account activity is correct. They should report any questionable charges to the respective provider and notify law enforcement promptly. The agency recommends that Supplemental Nutrition Assistance Program (SNAP) recipients check their Lone Star Card transactions for fraudulent activity. Individuals can do this by visiting YourTexasBenefits.com or using the mobile app. If they suspect SNAP fraud, they should call 2-1-1, select a language, and choose option 3 to report the fraud to the Texas Health and Human Services Office of the Inspector General. Affected individuals should also contact law enforcement and visit a local HHSC benefits office to replace their stolen benefits. Details of the Breach and Available Resources HHSC reports that the compromised data includes full names, addresses, phone numbers, dates of birth, email addresses, Social Security numbers, Medicaid and Medicare identification numbers, and other personal information. The agency offers two years of free credit monitoring and identity theft protection services to those affected. Individuals can also call 866-362-1773, using engagement number B139792, for further assistance. Contractor Employee Terminated Over Improper Access HHSC has notified one of its contractors, Maximus, about an employee suspected of misusing personal data from HHSC’s systems. Maximus terminated the employee for improperly accessing protected health information of Texans enrolled in state benefits between May 8, 2023, and February 28, 2025. The Texas HHSC Office of the Inspector General is conducting an investigation into these data breaches. For more information, visit the Texas Tribune. FAQs: About the Texas HHSC Data Breach What personal information was exposed in the data breach? The breach involved names, addresses, phone numbers, Social Security numbers, Medicaid and Medicare IDs, and other sensitive personal data of over 33,000 Texans. What should Texans do if they were affected by the data breach? Affected individuals should monitor their accounts for suspicious activity, review Lone Star Card transactions, report any fraud to HHSC and law enforcement, and use the free credit monitoring services offered. How is the HHSC responding to the data breach? HHSC is investigating the breach, providing two years of free credit monitoring, working with law enforcement, and has terminated employees and contractors responsible for improper access. Get the latest updates on workers’ compensation fraud and other critical industry news. Stay ahead by reading more insightful articles and case analyses on JacobiJournal.com. 🔎 Read More from JacobiJournal.com:
Investigators Tie Trio to $2.4 Million in Losses Across Southern New England
May 1, 2025 | JacobiJournal.com — Federal prosecutors have charged three Rhode Island men with stealing and trafficking catalytic converters worth more than $2.4 million in a major converter theft case. The charges stem from an investigation led by the FBI and local law enforcement agencies across New England. According to Acting U.S. Attorney Sara Miron Bloom, Kuron Mitchell (Newport), Alberto Rivera (Cranston), and Luis Aceituno (Providence) face charges of interstate transportation of stolen property and conspiracy. Additionally, Aceituno faces a separate charge for allegedly filing false tax returns. Thousands of Converters, Millions in Losses The Cranston Police Department began tracking patterns in converter theft in early 2022 after noticing a significant rise in reported incidents across the region. Over time, investigators connected the dots and identified the trio as key players in an organized group responsible for stealing more than 7,000 catalytic converters across Rhode Island, Massachusetts, and the greater Boston area. These components are vital for reducing harmful vehicle emissions and contain valuable metals like platinum and palladium, which contribute to their high scrap value—ranging from $300 to $1,500 each at the time. The widespread nature of this converter theft operation caused substantial financial losses for vehicle owners and insurers alike, prompting a coordinated law enforcement response across state lines. Alleged Scheme and Tax Fraud From January 2021 through November 2022, prosecutors allege the men targeted parked and unattended vehicles. Working in teams, they would quickly cut off the converters and then sell them to a Providence-based recycling company. FBI records and crime database reviews show Rivera sold 19 converters for $7,100. Meanwhile, Aceituno allegedly sold more than 2,100 converters, earning nearly $700,000. However, Aceituno reportedly failed to report this income to the IRS, leading to a tax liability of nearly $200,000. Broader Impact and Industry Response Federal authorities noted that the thefts created widespread financial strain, not just for vehicle owners, but also for insurers. In response to increased law enforcement efforts, catalytic converter claims have dropped significantly. According to State Farm data, theft-related claims fell by 74% in the first half of 2024 compared to the same period in 2023. Nonetheless, the average claim still cost nearly $2,900. Ongoing Investigations and Prosecutions This case is one of several high-profile prosecutions involving catalytic converter thefts. For example, prosecutors in Connecticut recently sentenced two men involved in a similar scheme. In another case last October, a ringleader in Massachusetts received a federal sentence after coordinating thefts from nearly 500 vehicles. The Rhode Island case remains under investigation by multiple agencies, including the FBI, the National Insurance Crime Bureau, and police departments across Rhode Island and Massachusetts. These include Cranston, Newport, Providence, and several university and municipal departments. Although charges have been filed, all three defendants are presumed innocent until proven guilty in a court of law. Source: U.S. Attorney, District of Rhode Island FAQs: About The Converter Theft What is converter theft? Converter theft involves stealing catalytic converters from vehicles, which contain valuable metals that can be sold for scrap. How are authorities addressing converter theft in Rhode Island? Law enforcement agencies are investigating theft rings, prosecuting offenders, and collaborating across states to reduce converter theft incidents. What impact does converter theft have on vehicle owners and insurers? Converter theft causes costly repairs for vehicle owners and drives up insurance claims, increasing premiums for all policyholders. For deeper insights on fraud, criminal enforcement, and regulatory actions affecting the insurance sector, visit JacobiJournal.com and subscribe to our weekly update. 🔎 Read More from JacobiJournal.com:
Heritage Sues Adjuster for Libel Over ’60 Minutes’ Report
April 30, 2025 | JacobiJournal.com — Heritage sues adjuster: Heritage Property & Casualty Insurance Co. has filed a libel and defamation lawsuit against independent adjuster Jordan Lee, just weeks after his appearance on 60 Minutes accusing Heritage of manipulating hurricane damage reports. Lee’s attorney, John Tolley, fired back, calling the Heritage sues adjuster case a retaliatory strike against whistleblowers. “Jordan Lee acted courageously to shine a light on systemic misconduct,” Tolley said. “This lawsuit is an attack not just on him, but on every Floridian who relies on fair insurance practices after a disaster.” Lee’s Allegations: Altered Estimates and Silenced Voices In a September 2024 broadcast of 60 Minutes, Lee claimed that Heritage and other insurers routinely slashed independent adjusters’ damage estimates to minimize claim payouts after Hurricane Ian. “I handled 46 of them; 44 of them were changed,” Lee told CBS. Some claims, he said, were reduced by as much as 98%. The controversy began in late 2022 when Lee and two other adjusters testified before a Florida House committee, accusing insurers of altering their reports without consent. The revised reports made it appear as though the original adjusters had recommended the lower figures. Heritage’s Side: Inflated Claims and Alleged Misconduct Heritage responded by filing a complaint in Hillsborough County Circuit Court, alleging that Lee deliberately inflated estimates to increase his commission-based compensation. The suit also claims that Lee violated policy guidelines by favoring replacement costs over repairs and failing to document damage properly. According to Heritage’s complaint, “When his misconduct was uncovered and his estimates were corrected, Defendant did not receive the compensation he expected. Consequently, Defendant returned to Texas and began falsely and publicly alleging that Plaintiff intentionally reduced his estimates.” The insurer argues that a third-party administrator had to spend considerable time revising Lee’s reports to align them with actual damage, policy terms, and coverage limits. Legal Experts and Whistleblower Concerns Despite Heritage’s assertions, legal experts view the lawsuit with skepticism. Bob Jarvis, a law professor at Nova Southeastern University, said the suit likely aims to intimidate rather than win. “This lawsuit will bankrupt Jordan Lee, even if he wins,” Jarvis stated. “The message is clear: whistleblowers beware.” Tolley agreed, calling it a “blatant attempt to silence and punish not only Jordan but other potential whistleblowers for doing or attempting to do the right thing.” Financial Fallout and Ongoing Investigations Following the 60 Minutes segment, Heritage’s stock dipped sharply. However, it has since rebounded, reaching a nine-year high, according to Yahoo! Finance. In 2022, Florida’s then-Chief Financial Officer Jimmy Patronis promised an investigation into insurer practices related to Hurricane Ian claims. As of now, that investigation has not produced any public findings. Heritage CEO Ernie Garateix responded to the initial wave of allegations last fall, saying: “Third-party field adjusters, like Jordan Lee, always have to collaborate with those higher up. The company Lee worked for during Hurricane Ian is no longer in business.” He also clarified that some desk adjuster names were omitted from final reports due to software issues, and that some revised estimates actually increased, benefiting homeowners. What’s Next Attorney Gregory Kehoe of Greenberg Traurig is representing Heritage. He declined to comment on the pending litigation. Tolley has not yet filed a formal answer or motion to dismiss. The Heritage lawsuit accuses Lee of libel, slander, defamation, and fraud, and seeks monetary damages and legal fees. The amended complaint can be seen here. FAQs: Heritage Sues Adjuster Lawsuit What is the Heritage sues adjuster lawsuit about? The lawsuit centers on Heritage’s claim that Jordan Lee made false public statements on 60 Minutes, accusing the insurer of altering hurricane damage reports. Why is the Heritage sues adjuster case significant? The case highlights tensions between insurers and independent adjusters, raising broader concerns about whistleblower protections in Florida’s insurance industry. What could be the outcome of the Heritage sues adjuster case? If Heritage wins, Lee could face significant financial damages. If Lee prevails, it may strengthen whistleblower protections and increase scrutiny on insurer practices. For the latest updates on legal settlements, disaster recovery, and insurance fraud, visit JacobiJournal.com. 🔎 Read More from JacobiJournal.com:
Cargo Theft Surges in 2024, Led by California, Texas, and Florida
April 30, 2025 | JacobiJournal.com — Cargo Theft Surges in North America, with California, Texas, and Florida accounting for more than half of all incidents in 2024, according to a newly released report by GearTrack and Verisk’s CargoNet. These states alone made up 54% of all reported thefts, as organized crime groups target key logistics corridors and multimodal hubs. Multimodal Hubs and Ports Under Threat The report highlights ongoing risks around California and Texas freight corridors, as well as near Chicago’s intermodal facilities. Additionally, Florida ports are seeing a concerning uptick in activity, underscoring the broader vulnerability of high-traffic freight routes. Thieves are increasingly drawn to high-volume shipping points where goods are temporarily staged, loaded, or in transit. As a result, companies moving freight through these areas face growing exposure to losses. High-Value Goods Are Top Targets While nearly all types of cargo face risk, several categories have emerged as especially attractive to criminals: These categories are favored not only for their market value but also due to their ease of redistribution and resale. Organized Crime Adopts Sophisticated Tactics Cargo Theft Surges: The report also emphasizes how organized theft groups are deploying more advanced schemes to avoid detection and maximize returns. Strategies now include: This evolving threat landscape highlights the need for real-time intelligence and enhanced verification processes. Industry Collaboration Offers New Tools for Prevention In response, GearTrack and CargoNet have partnered to provide 24/7 cargo recovery support and access to Verisk’s theft and fraud analytics tools. The collaboration will also launch the GearTrack Cargo Security Index, a monthly digest powered by CargoNet’s data to track national and regional theft patterns. “Through this partnership, customers will gain timely risk alerts and actionable insights,” the report notes, adding that real-time data can help logistics providers respond faster and adapt to new threat vectors. Protect your shipments and stay ahead of cargo thieves — visit CargoNet for expert prevention and recovery resources. FAQs: About Cargo Theft Trends What states saw the highest cargo theft in 2024? California, Texas, and Florida led the nation in cargo theft incidents in 2024, accounting for more than half of all reported cases. Which goods are most targeted in cargo theft cases? Food and beverages, household goods, and vehicles or accessories are among the most frequently stolen items in cargo theft operations. How can businesses protect against cargo theft? Companies can reduce cargo theft risks by using real-time tracking, verifying pick-up documents, and collaborating with industry security networks. Stay informed on cargo security, fraud trends, and insurance insights. Visit JacobiJournal.com for weekly updates and expert analysis. Read More from JacobiJournal.com:
Labor Organization Owners Sentenced in Union Fraud Scheme
April 14, 2025 | JacobiJournal.com – Labor organization owners sentenced in a high-profile union fraud case, shining a spotlight on corruption within labor institutions and the urgent need for accountability. Two Southern California labor organization owners will serve time in federal prison after admitting to a fraud scheme that embezzled more than $500,000 in union funds. Their sentencing underscores a broader crackdown on union-related financial crimes and highlights how misuse of worker contributions erodes trust in organizations designed to protect employees. This case marks another aggressive move by federal authorities to confront white-collar corruption in labor institutions. Officials emphasized that the ruling sends a message to leaders of labor groups nationwide: safeguarding union funds is a fiduciary duty, and those who breach it for personal gain will face serious legal consequences. Fraud Scheme Diverted Union Funds for Luxury and Travel According to the U.S. Department of Justice, the defendants ran a labor nonprofit allegedly dedicated to protecting workers’ rights. However, investigators uncovered that the organization was used as a front to finance personal luxuries. They diverted funds toward extravagant travel and high-end purchases, betraying the trust of union members in the process. Labor Organization Owners Sentenced Falsified Invoices and Shell Companies Used to Conceal Theft To mask the scheme, the pair falsified financial records, created fake invoices, and routed money through shell companies. These tactics were aimed at avoiding detection while continuing to misuse union funds. Prosecutors emphasized the significance of the betrayal, noting that such actions undermine confidence in legitimate labor movements. Federal Sentencing Underscores Severity Following a thorough investigation and prosecution, both individuals received multi-year federal prison terms and were ordered to pay restitution. The court’s decision sends a firm message: those who exploit positions of public trust, especially within labor organizations, will face serious consequences. Heightened Scrutiny for Union Oversight This case is part of a broader federal effort to increase oversight of labor organizations. As government agencies ramp up enforcement, unions are being urged to adopt tighter compliance measures and improve financial transparency. Employers and union representatives should review internal controls regularly to avoid costly liability or legal exposure. For more information on federal enforcement and union oversight, visit the U.S. Department of Justice – Office of Labor-Management Standards (OLMS). FAQs: Labor Organization Owners Sentenced What crimes were the labor organization owners sentenced for? They were sentenced for embezzling over $500,000 in union funds, falsifying invoices, and using shell companies to conceal the theft. How long will the labor organization owners sentenced serve in prison? Both defendants received multi-year federal prison terms along with restitution orders for the stolen union funds. Why is the labor organization owners sentenced case significant? It highlights the federal government’s aggressive stance on union fraud and underscores the importance of financial transparency in labor organizations. Stay informed about union fraud, compliance enforcement, and insurance-related legal actions at JacobiJournal.com. Subscribe for updates that matter to employers, investigators, and compliance professionals. Read More from JacobiJournal.com:
Ohio BWC Recoups Nearly $4K After Fraud Investigation
April 10, 2025 | JacobiJournal.com — Ohio BWC fraud investigation efforts led to a recent guilty plea and restitution recovery in Columbus. On April 10, 2025, the Ohio Bureau of Workers’ Compensation (BWC) successfully recouped $3,816 after a woman admitted to working while collecting disability benefits. This outcome underscores how even smaller-scale fraud cases remain a priority for state investigators. While the restitution amount may seem modest compared to multimillion-dollar schemes, the Ohio BWC fraud investigation highlights the agency’s commitment to protecting the State Insurance Fund. Every fraudulent claim, no matter the size, has a direct impact on employers who pay into the system and on injured workers who rely on legitimate benefits to recover. The case also demonstrates the role of the BWC’s Special Investigations Department (SID), which frequently acts on community tips to uncover fraud. By leveraging tips, surveillance, and employer cooperation, the department ensures accountability and reinforces that fraudulent actions will be detected and prosecuted. Ultimately, this conviction sends a strong deterrent message: individuals attempting to exploit the workers’ compensation system risk not only financial penalties but also criminal records and potential jail time. For honest workers and employers, the vigilance of the BWC protects the integrity of Ohio’s workers’ compensation program. Investigation Begins After Tip The Ohio BWC fraud investigation started when the Special Investigations Department (SID) received a credible tip suggesting that the claimant was engaged in outside employment while continuing to collect disability benefits. Acting on the report, investigators launched a full review, which included checking payroll records, cross-referencing tax filings, and interviewing potential employers. SID investigators also conducted surveillance, a standard tool in workers’ compensation fraud cases, to verify whether the woman was actively working despite her claim of disability. This layered approach not only confirmed that she had worked for four different employers but also documented evidence strong enough to secure a guilty plea in court. By responding swiftly to community reports, the Ohio BWC demonstrates how proactive fraud detection safeguards the system. Each Ohio BWC fraud investigation ensures that funds remain available to support genuinely injured workers, rather than being drained by fraudulent claims. Woman Worked for Multiple Employers While Receiving Benefits The investigation revealed that the woman had worked for four different employers while collecting benefits she wasn’t entitled to. Evidence showed that she consistently earned wages across different job sites, all while continuing to receive disability payments from the BWC. This type of activity not only violated the terms of her benefits but also represented a clear example of workers’ compensation fraud. Investigators highlighted that cases involving multiple employers can be particularly concerning, since the claimant actively seeks out income opportunities while deliberately concealing employment status from the Bureau. Such actions create unfair strain on the system and undermine trust in the workers’ compensation process, ultimately driving up costs for honest workers and employers. Guilty Plea and Full Restitution Recovered Ohio BWC Recoups: On February 19, 2025, she pleaded guilty to a first-degree misdemeanor. The judge acknowledged that the BWC had already recovered the full restitution amount of $3,816. Protecting the State Insurance Fund SID, a criminal justice agency within the BWC, continues to pursue individuals who defraud the workers’ compensation system. By doing so, it protects the State Insurance Fund and ensures that benefits remain available for injured workers who genuinely need them. Source: Ohio BWC Newsroom – Fraud Investigation Restitution FAQs: Ohio BWC Fraud Investigation What triggered the Ohio BWC fraud investigation? The investigation began after the BWC’s Special Investigations Department (SID) received a tip that the woman was working while collecting disability benefits. How much was recovered in the Ohio BWC fraud investigation? The Ohio BWC fraud investigation resulted in the recovery of $3,816 in restitution after the woman’s guilty plea. What charges were filed in the Ohio BWC fraud investigation? The defendant pleaded guilty to one count of workers’ compensation fraud, classified as a first-degree misdemeanor in Ohio. Stay informed on the latest fraud cases, enforcement actions, and workers’ compensation updates. Subscribe to JacobiJournal.com today for weekly insights. Stay updated! 🔎 Read More from JacobiJournal.com:
Public Adjuster Pleads Guilty to Defrauding Church After Hurricane
April 1, 2025 | JacobiJournal.com — Public Adjuster pleads Guilty: Andrew Aga, a public adjuster already serving time for defrauding Louisiana and Texas residents, pleaded guilty last week to defrauding Brotherhood Mutual Insurance Co. and a Georgia church. He stole millions after Hurricane Michael struck in 2018. The Fraudulent Scheme Aga, also known as Andrew Mitchell, defrauded Friendship Missionary Baptist Church in Albany, Georgia. The hurricane caused extensive damage, and Brotherhood Mutual Insurance paid the church $183,208 for repairs. A few days later, Aga and a construction company arrived, offering to maximize the settlement. Aga, affiliated with various companies like Loss Consultants of Texas and Mitchell Adjusting International, convinced Brotherhood Mutual to send him over $6 million. He forged the church leaders’ signatures and kept a portion of the funds, forwarding only about one-third to the church. Public Adjuster Pleads Guilty Background and Previous Convictions Aga, from Kemah, Texas, had a history of fraudulent schemes. He targeted homeowners, churches, and others across Louisiana and Texas, stealing millions. In 2023, he received a 20-year prison sentence for previous scams. Aga also left much of the church’s repair work unfinished. When the church questioned him, he falsely claimed the insurance company had withheld payments. Legal Consequences As part of his plea agreement in Georgia federal court, Aga faces up to 30 years in prison, restitution, and a $1 million fine. A Shocking Betrayal Acting U.S. Attorney Shanelle Booker expressed shock at the betrayal, particularly targeting a place of worship in the aftermath of a disaster. “The congregation trusted the defendant to help them repair their historic facility,” she said. The Role of the Georgia Insurance Commissioner Georgia Insurance Commissioner John King criticized Aga for exploiting victims already struggling with Hurricane Michael’s aftermath. Investigators held Aga accountable, ensuring justice for the church. Aga’s License and Final Words Aga, listed as a non-resident public adjuster in Georgia, had his license expire in 2022. Despite his criminal activities, he continued operating until authorities convicted him. Source: Full Article by The Insurance Journal FAQs: Public Adjuster Pleads Guilty Why did the public adjuster plead guilty in Georgia? He admitted to defrauding Brotherhood Mutual Insurance and a Georgia church after Hurricane Michael by forging documents and misusing funds. How much money was involved when the public adjuster pled guilty? The scheme involved over $6 million, with the church only receiving about one-third of the insurance settlement. What penalties does the public adjuster face after pleading guilty? He faces up to 30 years in federal prison, restitution payments, and a $1 million fine. Did the public adjuster who pled guilty have prior convictions? Yes, he previously received a 20-year sentence in 2023 for defrauding residents in Louisiana and Texas. Stay informed on insurance fraud cases and public corruption updates — subscribe to JacobiJournal.com today. Read More Articles:
Sugar Executive Charged With Stealing $28 Million From Mars Inc.
April 1, 2025 | JacobiJournal.com — Sugar Executive Charged: Paul Steed, a respected sugar market expert for Mars Inc., has been arrested and charged with stealing over $28 million from the candy giant. The 58-year-old from Stamford, Connecticut, stands accused of embezzling funds since 2013 through various fraudulent schemes. The Allegations Against Steed Steed, a dual U.S. and Argentine citizen, faces seven counts of wire fraud and two counts of tax evasion. Federal prosecutors allege that he diverted company funds to personal companies he set up, including Ibera LLC and MCNA LLC. From 2012 to 2020, Steed submitted false invoices from Ibera LLC to Mars, allegedly stealing nearly $580,000. Later, in 2016, Steed used MCNA to reroute millions of dollars from Mars, including over $11 million from the sale of Mars’s shares. Sugar Executive Charged Steed’s Lifestyle and Assets Steed’s lavish lifestyle raised red flags. Despite earning a $200,000 annual salary, he and his wife, Martina, lived beyond their means. They paid $2.5 million in cash for a Greenwich, Connecticut, property in 2023, and owned a $1 million home in Stamford. The judge’s detention order also revealed that Steed sent $2 million to Argentina over several years. He reportedly owns a cattle and tea ranch there. Mars Responds to Allegations Mars Inc. issued a statement condemning Steed’s actions as a betrayal by a single individual. The company emphasized its cooperation with law enforcement to resolve the issue swiftly while reaffirming its commitment to ethical standards in all its operations. Steed’s Role in the Industry Steed, now the executive charged in the Mars Inc. fraud case, was once considered a respected figure in the sugar industry. He served on national advisory boards, including the U.S. Agriculture Trade Advisory Committee for Sweeteners, and previously led the New York Sugar Club. Legal Proceedings Steed pleaded not guilty in federal court in Bridgeport and was ordered detained pending trial. The government has seized $18 million of the stolen funds, but several million dollars remain unaccounted for. Source: Insurance Journal – Full Article FAQs: Sugar Executive Charged Why was the sugar executive charged in the Mars Inc. case? He allegedly embezzled over $28 million through false invoices and shell companies. How long did the fraud by the executive last? Federal prosecutors say the schemes ran from 2012 to 2020. What assets did authorities seize from the executive? The government seized $18 million, though several million remain unaccounted for. What legal penalties could the executive face? He faces seven counts of wire fraud, two counts of tax evasion, and a lengthy federal prison sentence if convicted. Stay informed on major fraud investigations and corporate accountability cases — subscribe to JacobiJournal.com today. Read More Articles: