Team Credited with Being Integral to the Success of One of the Largest Workers’ Compensation Healthcare Bribery Schemes Ever Uncovered in San Diego County
SAN DIEGO, Nov. 17, 2016—ICW Group Insurance Companies, a group of property and casualty carriers, proudly announced today that the National Health Care Anti-Fraud Association (NHCAA), a national taskforce focused on fighting health care fraud, awarded ICW Group’s Special Investigation Unit (SIU) “Investigation of the Year” for its significant contribution to the successful resolution of Operation Back Lash—one of the largest workers’ compensation health care bribery schemes ever uncovered in San Diego County. Michael Bender, assistant vice president and head of ICW Group’s SIU team accepted the award on behalf of the company at NHCCA’s 2016 Annual Training Conference in Atlanta.
“We’re proud to have partnered with the FBI, California Department of Insurance, San Diego County District Attorney’s Office, and other law enforcement agencies and carriers to detect, deter and defeat one of the largest fraud crime rings in the industry,” said Bender.
The Operation Back Lash investigation defeated a bribery scheme involving doctors, chiropractors, medical providers, lawyers and their associates that bought and sold patients like cattle—supplanting patient care with greed. The criminals had defrauded insurance carriers and their customers for more than $50 million.
The investigation rolled out in two phases. Phase one concluded in November 2015—it resulted in eight medical professionals and associates being charged in a $25 million bribery scheme. The second wave was in January 2016 with an additional 13 indictments.
Using its propriety antifraud analytics tool—Analysis Investigation Module (A.I.M.™)—ICW Group provided law enforcement agencies with actionable insights that helped authorities bust the crime ring.
“A consortium of our top talent developed this first-of-its-kind platform to move at the speed of fraud,” said Bender. “We plan to continue sharing our data and intel with law enforcement, and look forward to accelerating our commitment to protecting our customers from fraud rings.”
About ICW Group
Based in San Diego, ICW Group Insurance Companies is the largest privately held group of insurance companies domiciled in California. Quoting more than $3 billion annually, ICW Group represents a group of Property, Auto and Workers’ Compensation insurance carriers, including Insurance Company of the West and Explorer Insurance Company. ICW Group is recognized nationally as an industry leader in helping policyholders achieve fewer and less costly claims, and is committed to meeting the needs of its policyholders and elevating the trusted agents and brokers who advise them.