A former rural carrier in Florida was sentenced to two years in prison and ordered to pay nearly $650,000 in restitution for falsely claiming workers’ compensation.
The former employee suffered an injury at work in 2000. She filed for benefits with the Labor Department’s Office of Workers’ Compensation Program, or OWCP.
She told health care providers that the pain was so bad that she could hardly move or even shower. She sought treatment for mental health issues as well as the physical injury because of the anxiety and depression she said resulted from the injury curtailing her once active, full life.
In 2014, an agent with the Postal Service’s Office of Inspector General, or OIG, sensed something amiss in the data. OIG agents spent a few weeks observing the woman’s activities and found that she went to the gym regularly, planted trees in her yard and moved boxes around the garage….
Insurance fraud involves making false or exaggerated claims to an insurance provider.
- Hard Fraud: Someone deliberately causes a loss (e.g., setting fire to a warehouse or staging a car accident) specifically to collect a payout.
- Soft Fraud: More common and often viewed as “victimless” by the perpetrator. It involves exaggerating a legitimate claim, such as overstating the value of stolen items in a home burglary to cover the deductible.