Carrier’s SIU Team Credited for Significant Role in Multi-Phased, Ongoing Investigation
SAN DIEGO, Jan. 9, 2018 — ICW Group Insurance Companies, a group of property and casualty carriers, announced today that the significant contribution made by its Special Investigation Unit (SIU) assisted in the conviction of Beverly Hills Radiologist Ronald Grusd and two of his corporations, California Imaging Network Medical Group and Willows Consulting Company. Dr. Grusd and his companies were convicted by a federal jury of fraud and bribery charges in connection with a massive health care-fraud scheme involving the State of California’s Workers’ Compensation program (Case Number: 15cr2821-BAS).
According to the evidence presented in federal court, Dr. Grusd and his companies paid kickbacks for patient referrals from multiple Southern California clinics in order to fraudulently bill insurance companies over $25 million for medical services. They were originally indicted by a federal grand jury in November 2015, when the U.S. Attorney’s Office and the San Diego District Attorney’s Office, working in conjunction with the Federal Bureau of Investigation and the California Department of Insurance, announced multiple arrests arising from “Operation Back Lash” — a long-term, proactive health care investigation targeting corruption and fraud in the California Workers’ Compensation system. ICW Group SIU’s assistance with the investigation dates back to 2013 and last year, the team received the “Investigation of the Year” award by the National Health Care Anti-Fraud Association for their significant contribution.
“This conviction is a testament to ICW Group’s highly aggressive approach to fighting fraud and our long-standing partnership with federal and local law enforcement agencies. We are committed to protecting our customers from being victimized by work comp fraud schemes, in whatever form and scale they may take,” said Michael Bender, assistant vice president and head of ICW Group’s SIU team. “The impact of these large scale criminal cases has already resulted in millions of dollars in claim savings for our policyholders, and will continue to for years to come.”
Grusd’s conviction represents a significant step in this multi-phased and ongoing investigation which has resulted in federal and/or state charges against nearly 40 individuals and corporations, including doctors, attorneys, marketers and providers of medical services and devices. Four other defendants charged with Dr. Grusd – who were alleged to have received bribes in exchange for patient referrals have already pleaded guilty and are cooperating with the continuing investigation while awaiting sentencing.
For more information about ICW Group’s commitment to the fight against fraud, please visit our Policyholder Center website for additional details and free anti-fraud resources.
About ICW Group
Based in San Diego, ICW Group Insurance Companies is the largest privately held insurance company domiciled in California. Quoting more than $3 billion annually, ICW Group represents a group of Workers’ Compensation, Property and Auto 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 while elevating the trusted agents who advise them. For more information, visit ICW Group’s website, Twitter and Facebook pages.