IWIF Claimant, Former Policyholder Busted for Fraud

Carlos Cruz, a painter employed by Maryland Management, was recently found guilty of felony theft over $500 against the Injured Workers’ Insurance Fund (IWIF) in Montgomery County District Court.

Judge C. J. Vaughey sentenced Cruz to 18 months incarceration, suspended, 18 months of supervised probation and ordered him to pay IWIF restitution in the amount of $1,192.71. In addition, Cruz was ordered to pay a $500 fine and $50 court fees.

Cruz alleged he injured his right knee while working for Maryland Management. He collected temporary total disability benefits from IWIF from January 2002 to April 2002 and again in November 2002 through June 2003.

An official from the management company alerted IWIF’s Special Investigations Unit to possible claimant fraud due to suspicious circumstances surrounding the claimant’s alleged injury. IWIF’s investigation reportedly revealed Cruz was collecting benefits from IWIF while he was employed as a carpenter for a construction company located in Middle River, Md. from May to June 2003.

In another recent case, a routine premium audit performed on a current IWIF policyholder uncovered a fraudulent certificate of insurance submitted by a former IWIF policyholder.

In September 2004, Dave R. Rajeshkumar, trading as R. Rajesh Home Improvement, reportedly presented a false IWIF certificate of insurance to Michaelson, Connor and Boul, a housing management firm and IWIF policyholder.

Upon verification, the IWIF auditor discovered the certificate had been altered to reflect Rajeshkumar had workers’ compensation insurance coverage from June 10, 2004 to June 10, 2005. The case was then assigned to IWIF’s Special Investigations Unit. IWIF records show Rajeshkumar had canceled his coverage on June 10, 2003.

During the investigation, Rajeshkumar reportedly originally denied changing the dates on his certificate. He later admitted altering the certificate but claimed that he thought his policy would automatically reinstate itself if he simply changed the dates on his old certificate of insurance.

Rajeshkumar pleaded guilty to an agreed statement of facts in Baltimore City District Court. Judge Timothy Doory sentenced Rajeshkumar to 18 months of unsupervised probation and ordered him to pay $57 in court costs.