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February 2005

Area of Interest: OSHA Reminds Employers to Post Injury/Illness Summaries Beginning February 1

Beginning February 1, employers must post a summary of the total number of job-related injuries and illnesses that occurred last year, the Occupational Safety and Health Administration (OSHA) announced today. Employers are only required to post the Summary (OSHA Form 300A) -- not the OSHA 300 Log -- from Feb.1 to Apr. 30, 2005.

The summary must list the total numbers of job-related injuries and illnesses that occurred in 2004 and were logged on the OSHA 300 form. Employment information about annual average number of employees and total hours worked during the calendar year is also required to assists in calculating incidence rates. Companies with no recordable injuries or illnesses in 2004 must post the form with zeros on the total line. All establishment summaries must be certified by a company executive.

The form is to be displayed in a common area wherever notices to employees are usually posted. Employers must make a copy of the summary available to employees who move from worksite to worksite, such as construction workers, and employees who do not report to any fixed establishment on a regular basis.

Employers with ten or fewer employees and employers in certain industry groups are normally exempt from federal OSHA injury and illness recordkeeping and posting requirements. A complete list of exempt industries in the retail, services, finance and real estate sectors is posted on OSHA's website.

Source: Occupational Safety and Health Administration

Area of Interest: Modesto Chiropractor, Two Associates Nabbed in Alleged $10 Million Workers’ Compensation Scam
Insurers were allegedly billed for services never rendered;
investigators believe losses could exceed $10 million as the investigation continues

A Modesto chiropractor and two employees were arrested early Thursday on charges that they repeatedly billed for services that were unnecessary or never rendered from 1996 through 2004, potentially costing insurers more than $10 million.

Chiropractor Wilmer Dorado Origel, 44, of Modesto, is the owner and operator of the businesses involved in the alleged fraud. His associates, Rebecca Marie Benedict, 44, of Modesto, and Robin Elaine Barney, 40, of Oakdale, were also taken into custody. All three were booked into the San Joaquin County jail and charged with multiple felony counts, including insurance fraud, grand theft, and practicing medicine without certification. Origel’s bail was set at $1 million, while bail for Benedict and Barney was set at $300,000 each.

Investigators believe that Origel conspired with his associates to illegally over-bill workers’ compensation and auto insurance carriers for services never rendered, services not medically necessary, and for services beyond the scope of their licensed authority to perform. Origel owned and controlled Med-1 Medical Center, P.C., and Unique Healthcare Management, Inc., both based in Modesto.

Source: State of California

State: New York

Area Of Interest: Nationwide to Cut Auto Insurance Rates in 2005

The New York State Insurance Department today announced that Nationwide Insurance will reduce auto rate premiums for their New York customers this year, making them the fourth insurer to do so and bringing to $166 million the total consumer savings announced to date.

Nationwide’s policyholders will see on average a 5.2 percent rate cut on policies that are renewed on or after June 15, 2005. These reductions will to varying degrees lower all of the components within any given auto insurance policy: bodily injury, property damage, personal injury protection, comprehensive (fire & theft) coverage, and collision. The Columbus, Ohio-based Nationwide Insurance has about 214,000 auto insurance policyholders in New York State, or 3.3 percent of the market share.

In an unprecedented move, the New York State Insurance Department in November 2004 asked Nationwide and 12 other auto insurance carriers cumulatively serving more than 60 percent of the state’s drivers to meet with the Department’s senior management team to discuss possible rate reductions in light of compelling industry data indicating that losses had dropped substantially between 2002 and the third quarter of 2004. In addition to Nationwide ($18 million), GEICO ($100 million), Progressive ($33 million) and MetLife ($15 million) are the other insurers who will cut auto rate premiums in 2005. State Farm and Progressive reduced their rates in 2004, as well. Meetings with other carriers are continuing.

Source: State of New York



Area of Interest: OSHA Cites Albany, Ga., Company Following Warehouse Fatality

Lack of Fall Protection Brings Over $50,000 in Proposed Penalties

The U.S. Labor Department's Occupational Safety and Health Administration (OSHA) has cited Diversified Ag Services Inc. for exposing workers to fall hazards at the company's bulk fertilizer warehouse in Albany. The agency is proposing penalties totaling $51,250.

OSHA began an investigation on Aug. 26 after being notified that a worker had died from injuries sustained in a fall from an elevated forklift platform. According to the OSHA investigative report, the employee was struck by a piece of electrical conduit as it was being removed from overhead beams, causing him to lose his balance and fall eight feet to the floor below.

The company received one willful citation, with a proposed penalty of $49,000, for failing to provide standard guardrails on the pallet or fall arrest equipment for the employee. A "safety cage" equipped with standard guardrails was available in the warehouse. OSHA issues a willful citation when an employer has shown an intentional disregard of, or plain indifference to, the requirements of the Occupational Safety and Health Act and regulations.

OSHA also issued two serious citations unrelated to the fatal accident, with total proposed penalties of $2,250, for failing to have a "lockout-tagout" program that would prevent workers from being caught in or struck by energized equipment during repair or maintenance, and for operating a forklift with a defective safety signal.

Source: Occupational Safety and Health Administration

State: Texas

Area of Interest: OSHA Proposes $128,000 in Penalties Against DeSoto, Texas-based J&R Landmark Construction Corp. for Alleged Safety Violations in Houston

A DeSoto, Texas-based construction company's alleged repeated failures to properly erect scaffold equipment and follow safety standards at a Houston, Texas, construction site has resulted in proposed penalties totaling $128,000 from the U.S. Department of Labor's Occupational Safety and Health Administration (OSHA).

The alleged repeat violations include failing to provide guywires or ties to prevent the scaffold from tipping over and planking; failing to provide guardrails on scaffolds; failing to provide employees with ladders for access; failing to properly deck the scaffolds; failing to provide hard hats as protective equipment, and failing to provide toeboards. OSHA issues a repeat citation when an inspection reveals a violation for which the employer had been previously cited, and where, upon re-inspection, a substantially similar violation is found.

Other companies owned by J&R Landmark's owner, Ramiro Rodriguez, have been inspected by OSHA seven times for similar violations since 1998, resulting in fines totaling $272,200 which the company still owes.

Source: Occupational Safety and Health Administration

State: Florida

Area of Interest: Florida Man Wanted in Family Slip and Fall Scheme Is Awaiting Extradition in California

A 30-year-old man wanted in Florida since 1995 on numerous felony charges for his alleged role in his family’s nationwide “slip-and-fall” fraud scheme is in custody in California awaiting extradition.

Christopher Michael Evans, whose last-known Florida address was 5612 Hollywood Blvd. in Hollywood, was arrested January 13 in Mountainview, California, on an unrelated charge. He is the fifth member of the family, including his mother, to be apprehended.

Florida has consistently produced the nation’s highest number of insurance fraud arrests or convictions for each of the past several years.

Evans was believed to have been involved in a scheme to bilk insurance companies out of thousands of dollars by faking accidents in businesses in several states. Evans is charged with racketeering, organized fraud, six counts of insurance fraud, and eight counts of grand theft.

Source: State of Florida

State: Georgia

Area of Interest: Oxendine: Life Company to Refund $1.3 Million in Premiums to Soldiers

Insurance Commissioner John W. Oxendine said as a result of an investigation by his

office, American Amicable Life Insurance Company of Texas will refund $1.3 million in life insurance premiums paid by certain active-duty soldiers trained at Ft. Benning.

The company agreed to issue refunds to soldiers at Ft. Benning who were solicited and

sold term life insurance policies while they were in a training brigade during the year 2002. It is estimated that 901 soldiers will be eligible for the current round of refunds. Refunds will include all sales of the “Horizon Life” product, including lapsed or terminated policies as well as those currently in force. The amount of each refund will vary depending on how much the soldier agreed to pay for insurance plus any additional funds accumulated under the policy.

American Amicable will notify eligible soldiers by mailing a notice to the permanent

residence listed on their application. Soldiers will be required to submit an affidavit that affirms that the policy was sold while the soldier was in basic training. The soldier will have 180 days from the date of mailing to return the request for refund, with affidavit, to the company. If the soldier is outside of the continental US, that period will be suspended during the time the soldier is away.

Source: State of Georgia

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