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The first thing that comes to mind when most of us hear the phrase “workers’ compensation fraud” is a worker faking an injury in order to get workers’ comp to pay the disability benefits when they are actually healthy enough to work, or else suffering a work injury but then filing claims to get workers’ compensation to pay for the treatment of the worker’s pre-existing health problems in addition to the treatment for the work injury. 

While some people certainly have received criminal charges after filing fraudulent claims for workers’ compensation, the workers’ comp claims process is sufficiently thorough that employers have ample opportunity to dispute suspicious-looking claims.  Employees are not the only ones who can be charged with fraud for lying in order to enrich themselves at the expense of funds meant to pay for the treatment of large numbers of injured workers; employers can also receive charges for financial crimes if they make false statements in order to avoid paying for the workers’ compensation insurance the law requires them to carry. 

If you are facing criminal charges for making false statements to a workers’ compensation insurance company, contact us for a Los Angeles fraud crimes defense lawyer.

Former Sheriff’s Reserve Officer Accused of Defrauding Workers’ Compensation Insurance

In 1993, Simon Semaan began working as a sheriff’s reserve officer for the Orange County Sheriff’s Office, and he excelled in his work to such a degree that, in 2008, Gov. Arnold Schwarzenegger appointed him to a state private security disciplinary review committee.  By 2021, Semaan also owned a security guard staffing firm called Pacwest Security Services and another company called PSSM Inc.  He did not carry workers’ compensation insurance for the former company; for the latter company, he carried two workers’ compensation policies, but he underreported the number of employees on the payroll, in order to lower his insurance premiums.

By 2021, Semaan had allegedly defrauded California’s workers’ compensation insurance program $17 million in insurance premium payments, making his case the biggest insurance premium fraud case in the history of Los Angeles and the second biggest in California history. 

Upon his arrest, the Sheriff’s office terminated his employment.  Semaan, 54, has been charged with seven felony counts of fraud and seven enhancements for financial crimes in excess of $500,000.  If convicted of all charges, he could receive a sentence of up to 16 years in state prison.  Semaan posted $4 million bails and is currently free.  He has entered a plea of not guilty and is presumed innocent until proven guilty at a jury trial.

Contact the Manshoory Law Group About Accusations of Insurance Fraud

When it comes to insurance payments, numbers are fuzzier than they may seem, but making false statements in order to receive money from an insurance company or to avoid paying money to one is a crime.  A Los Angeles criminal defense lawyer can help you if you are being accused of insurance premium fraud or another kind of fraud involving insurance companies.  Your initial consultation is always free, so contact us at Manshoory Law Group in Los Angeles, California, or call (877)977-7750 to discuss your case.

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