Tuesday, September 29, 2015

Don't Look At Me

Calling it "one of the largest insurance fraud scams in California history," the Los Angeles Times yesterday reported on the release of the grand jury indictment transcript made public Friday.

The story highlights some of the grizzly details of botched surgery, 21 victims coming forth with nearly unbelievable tales of a greedy physician run amok within the California system.

Dr. Munir Uwaydah is allegedly the mastermind behind all of the criminal activity - from medical misdeeds to kickbacks, payola, extortion and even murder.

Uwaydah is just one small example of a workers' compensation system out of control with illegal, fraudulent behavior.
"Don't look at me... EYE didn't do it!"

There is also the State Compensation Insurance Fund lawsuits naming virtually every applicant oriented household name we've all come to recognize of the past couple of decades: names like Drobot, Capen, Sobol, Landmark, Rosen, Hunt, Larsen, etc. ad nauseum.

Most of the industry thinks all of this is just terrific - big names, big time fraudsters, criminals are getting their just rewards and the system is ridding itself of millions of dollars of cheating so more money can get to where its supposed to go.

But wait a minute - should we be so congratulatory? I mean, why NOW, after somewhere between 20 and 30 years, are we NOW so pleased that criminals are being rooted out and forced to come to terms with their malfeasance? Why didn't this happen earlier? Why did we need to incur millions of dollars in damage, and dozens of lives put at risk, to finally do something about purported misdeeds?

Let me put it bluntly - we are a pathetic group of complicit non-doers either afraid to challenge malfeasance, or simply not interested because "it's somebody else's job."

I have had people come to me through out the years with tales of wrong doing by all of these same folks that are named in the indictments and lawsuits, but nobody was willing to give details, name names, provide documentation or testimony.

Law enforcement can't do its job unless it has evidence. District attorneys won't take a case unless they can prove criminal activity, and again, without names, details and documentation, nothing will get done.

The State Fund suit alleges criminal activity dating back to the mid-2000s, over ten years ago, and that damages incurred total tens of millions, if not hundreds of millions, of dollars as a result of these alleged schemes.

But why was State Fund so complicit in the beginning? Why weren't the patterns of wrongful behavior detected earlier, and contested earlier? Why did State Fund spend millions of dollars feeding the conspiratorial actions of the defendants before figuring it out?

And truth is, State Fund didn't really incur the damage - they were just a conduit. All of the damage that State Fund alleges is really damage its policyholders incurred. In reality, State Fund just passes the experience buck down the food chain.

Oh, and don't think for a minute that this particular routing of fraudulent and criminal vendors will stop any activity. I had earlier blogged, as has Joe Paduda, about internal fraud and misdeeds that goes unexposed and unpunished, all because this industry tolerates anonymity to protect the innocent.

I'm not criticizing the current routing of criminals out of the system. On the contrary, it's about time and I hope it sends a message.

But I suspect that the real message being sent to the narcissistic anti-socials perpetrating large scale work comp crime is just to be more careful, because people are loath to blow the whistle.

To quote cartoon character Bart Simpson, "Don't look at me! I didn't do it, nobody saw me do it, can't prove a thing."

Right...

2 comments:

  1. I know this kind of thing will continue but I do hope the media will begin to focus more on these kinds of work comp fraud cases and stop focussing on the injured workers, it sucks being stereotyped!

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