Hey Steve, Get Your Head Out Of The Sand!

Tuesday, December 18, 2007 | 0

It’s been almost a year since Californians Injured At Work members and interested parties met with newly elected Insurance Commissioner Steve Poizner in his office on Capitol Mall.

We can still hear his mantra: "I simply will not tolerate any kind of insurance fraud in California. My fraud investigators are always hard at work, following leads and helping to put fraud perpetrators where they belong - behind bars. I encourage anyone who is aware of fraud schemes to contact my department and help bring these scam artists to justice."

Is he serious or is this just more political spin from his Department of Insurance?

His latest press release extols the fact that his department was instrumental at securing the convictions for insurance fraud of two managers of a Roseville Raley’s store who pressured their employees to use their personal health insurance to take care of on-the-job injuries, even going to the extreme of giving those employees money from the store to pay their co-payments so that they could enjoy barbecues to reward them for an injury free workplace.

I’m sure that Raleys will most probably pay their fines for being such good company employees. But what about the real fraud that goes on in this workers' compensation benefits delivery system that always seems to be so broken and dysfunctional; the fraud that takes it’s toll in human tragedy while the insurance companies post record mega-million dollar profits. Who is looking out for injured worker rights that are violated en masse on a daily basis by big insurance?

We lose track of the fact that workers' compensation is about workers, not about insurance industry profits as our governor seems to be so concerned about. Of course he’s concerned; if he doesn’t produce favorable legislation to the insurance industry, he doesn’t get buckets of campaign money from them. After all they don’t give it to him simply because he’s a nice guy, they’re paying for influence.  And in many cases, these occupational injuries are caused by the gross negligence of our employers who simply don’t care about workplace safety anymore since they seem to have the ear of the legislature and virtual control of the benefits delivery system.

But then it’s a no-fault system right? Reality is that as far as the insurance companies are concerned, it’s your fault for getting injured in the first place and they certainly show that animosity in the way they clog the courts with frivolous litigation that brings the system to a virtual standstill at times.

And now the courts are producing decisions that erode in our rights to privacy with a recent decision down in San Luis Obispo that deals with the issues of governmental immunity. Do we waive our constitutional rights when we report an on-the-job injury to our employers? Sure seems like it. Many injured workers including this writer have brought prima facie cases of insurance fraud to the attention of the Department of Insurance Fraud Unit during this year only to have them hidden and buried for posterity.

But then there is a built-in conflict of interest in the Department of Insurance. They receive money from employers to supposedly combat insurance fraud, which they distribute to district attorneys around the state to reward them for successful fraud prosecutions even if the so-called perpetrators are innocent of any crime. Take the example of former Town of Atherton 9-1-1 police dispatcher Anita Blick, who has had her life ruined and is now in debt to the tune of over $150,000 because Jim Fox, a San Mateo County prosecutor, chose to railroad her into not a fraud conviction, but a sin of omission for which she served 60 days in the county jail. Her kangaroo court conviction was vacated by the court of appeals in a unanimous vote. What if she didn’t have the resources to mount a successful appeal? Would a public defender have had the initiatve to go that extra mile for her?

Hey Steve, get your head out of the sand and start listening to the people of the state. Don’t say you’re going to get rid of the fraud unless you really intend to. And if you can’t seem to find it, ask any injured worker. They have to deal with it every day. After all, the laws have to be interpreted equally and fairly. It’s not about money and power, it’s about competent medical treatment and getting these people back to work, not throwing them on the trash heap of society.

Just the thoughts of an injured worker.

<i>Sam Gold is the volunteer director of Californians Injured At Work. He also produces the “Injured On The Job” cable television show.</i>