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New Jersey Workers’ Comp Case Shines Light on a Different Type of Fraud

New Jersey Workers’ Comp Case Shines Light on a Different Type of FraudA New Jersey women was recently arrested for theft after she allegedly collected over $46,000 in fraudulent workers’ compensation benefits. Workers’ comp fraud is not uncommon, but in this particular case, the funds were not even meant for the woman in the first place. Wanda Berry, 53, of Jersey City, was indicted on charges of second-degree insurance fraud and third-degree theft by deception in an indictment handed up by a state grand jury in Trenton.

Berry had been collecting her mother’s workers’ comp benefits for nearly three years after her death, which occurred in November of 2014. According to the indictment, beginning in 2015 Berry falsely represented to New Jersey Manufacturers Insurance Group (NJM) that her mother was alive and in a nursing home in order to continue receiving the $1,400 in insurance benefits each month. Once again in 2016, Berry claimed that her mother was alive and in hospice care, even providing a fraudulent doctor’s note to support her claims.

This recent case shines light on a different type of workers’ compensation fraud. Most fraud prevention efforts focus on the more common types of workers’ comp fraud such as false or exaggerated claims or medical provider-related fraud. The type of fraud allegedly committed by Wanda Berry can be more difficult for insurance providers to uncover.

According to acting Insurance Fraud Prosecutor Tracy M. Thompson, this indictment “sends a message that anyone caught engaging in this kind of insurance fraud faces serious charges.” Thompson also noted that many important fraud cases have started with anonymous tips. Berry allegedly managed to deceive the NJM Insurance Group on more than one occasion, but agents can hopefully learn something from this case in order to prevent similar occurrences in the future.

Agents should manage potentially fraudulent claims in the same manner they manage legitimate ones; with consistent and ongoing attention. In Berry’s case, an aggressive claims manager may have been able to identify the fraudulent activity sooner by arranging a visit to the benefits recipient from an adjuster, or doing more research on the “evidence” provided about the deceased woman’s whereabouts.

Agents, claims managers or insurance adjusters in New Jersey who are concerned about insurance fraud and have information regarding fraudulent activity can report it anonymously by calling the toll-free hotline at 1-877-55-FRAUD, or visiting their Web site.

About ASIA Workers’ Compensation

Associated Specialty Insurance Agency, Inc. has been “The Workers’ Compensation Specialist for Brokers and Agents” for the past two decades and is committed to providing brokers and insurance agents across the East Coast with expertise and services to develop a Workers’ Compensation policy. For more information about how we can assist you with claims management, anti-fraud measures, and more call (610) 543-5510 to speak with one of our professionals.

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