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Jamie Serne of Fillmore, CA, Sentence for Workers’ Compensation Fraud

bandage-close-up-hands-1571172-300x200Jamie Serne of Fillmore, CA, pleaded guilty to committing workers’ compensation fraud, according to District Attorney, Gregory D. Totten. Serne is accused of making false statements to receive worker’s compensatory benefits.

As a result, D. Totten announced that Serne would be sentenced to formal probation for 36 months. One of the conditions of his probation is providing compensation to the insurance brokerage company, American Claims Management, of about $27,995. Along with this, Jaime has to serve in Ventura County Jail for almost 180 days.

These charges came about after an incident on May 12, 2010. That day, Seine was working as a truck driver in Santa Paula at Agromin, a landscaping supply company, when his right shoulder was injured quite badly. His injury was severe enough that it merited a short-term total disability leave. Seine even had surgery on his shoulder on September 10, 2010.

As part of the workers’ compensation, Serne remained on leave and continuously collected his benefits of two-thirds of his tax-free salary. Workers’ compensation, similar to insurance, offers medical benefits and wage replacement to those employees who have been injured during their work. However, the employees give up their rights to sue their employer for their negligence in exchange for the stipend.

On February 12, 2012, after more than one and a half years, Agromin was informed by an anonymous source that Serne had been working on cars and participating in strenuous activities while on his disability leave. Agromin contacted an administrator involved with workers’ compensation insurance policies, which led to private investigators surveilling Serne’s activities.

Following the tip, nearly eight hours of video footage was collected by investigators showing Jaime Serna fixing cars at his home. Not only was he observed taking out a radiator from an engine, but he was purportedly also seen replacing heavy wheels, tires, and car batteries. He was also allegedly seen picking up a 36-pound jack and placing it in his garage. It is not clear how long Serna had truly been incapacitated for or how long he had been allegedly defrauding Agromin and their insurance company.

According to records, Jaime Serna provided a deposition as well as lied about his injuries under oath on July 2012. Worker’s compensation fraud like this occurs when employees hide information or provide wrongful statements to receive their compensatory benefits. 

The goal of the workers’ compensation program, also called workman’s comp, is to protect employees as well as employers from lawsuits. However, according to NICB (National Insurance Crime Bureau), workers’ compensation fraud is the fastest-growing fraud type among insurance frauds. Anyone accused of worker’s compensation fraud should immediately hire a qualified lawyer.

Workers’ compensation fraud cases harm business owners who provide their employees with all sorts of insurance coverage. Because of fraudulent cases, employers have to pay a higher premium, increasing the cost of doing business. This leads to pay cuts and a lack of bonuses and other benefits for employees. 

It is estimated that annually, almost $7.2 billion have to be paid by the insured employers due to these fraudulent cases. Much of this debt is passed onto the local public, as coverage is mostly from state-run insurance companies.

Source: 7.26.19 Jaime Serna