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FDIF Officials Pursue Fraud Matter in Florida

A Georgia insurance agent is in trouble after allegedly accepting thousands of dollars in premiums for workers’ compensation policies that he never purchased.

 

According to the Florida Division of Insurance Fraud, William David Rodeffer III of Folkston, Georgia, moved to Yula when his company expanded into the Sunshine State. Although Mr. Rodeffer was denied a Florida license because of his criminal past, he nevertheless continued to sell policies for almost three years. Two clients – a 91-year-old business owner and a local American Legion Post – both made regular premium payments, only to learn that they were not covered after submitting claims. Collectively, the two alleged victims lost about $70,000, between the premium payments and the uninsured costs they paid. Investigators believe there are other victims as well.

 

Mr. Rodeffer, who was booked into the Duval County Pre-Trial Detention Center, faces similar charges in Georgia and was previously charged in Nassau County in 2014.

 

Workers’ Compensation System

 

Last year, the Florida Supreme Court upheld the “exclusive remedy” portion of the workers’ compensation law, even though 2010 changes essentially gutted the system, at least according to many advocates. But the question remains unsettled, as several more court challenges are still pending.

 

Workers’ compensation is no-fault insurance that pays cash benefits for:

 

  • Occupational diseases, like repetitive stress disorder and breathing problems; or
  • Trauma injuries, including broken bones and internal injuries.

 

Claimants need only prove that the injury occurred at work.

 

Employer Fraud

 

In the above case, the alleged fraud scheme hurt the employers, who believed they were policy owners. But in most cases, injured workers are the fraud victims.

 

Media reports give the impression that false claims, false statements, and other forms of claimant fraud are rampant and cost billions. But, in reality, such matters only account for around 2 percent of Florida workers’ compensation claims. Conversely, employer fraud drains millions of dollars from the system each year. Some common fraud schemes include:

 

  • Miscategorization: Many employers categorize high-risk employees, like drivers and construction workers, as low-risk employees. This illegal tactic lowers their premium payments, resulting in less money for injured workers.
  • Misclassification: Many companies – even large ones – have no legal “employees.” They classify all their workers as independent contractors so they do not have to buy insurance.
  • Informal Payments: Some employers offer under-the-table reimbursements to injured workers if they agree not to file claims. In many cases, the promised money only partially comes, and the injured worker loses the chance to obtain maximum cash benefits.

 

Given the amount of fraud, along with recent changes in the law, it is more important than ever to have a strong advocate as your claim works its way through the system.

 

Partner with a Tenacious Lawyer

 

For prompt assistance with a workers’ compensation claim, contact an aggressive personal injury attorney in Tampa. Lawyers do not charge upfront legal fees in workers’ compensation matters.

Let our Tampa personal injury attorneys get started on your claim.

let us focus on fighting the insurance company so that you can focus on getting better.