CPWC15 – Workers Compensation Fraud


CPWC15  FRAUD


CLAIMS PRACTITIONER IN WORKERS’ COMPENSATION

Module 15 – Workers’ Compensation Fraud

In this 15th module – Workers’ Compensation Fraud, we will continue to look at the actions of the parties within the Workers Compensation system and learn if and how those actions constitute criminal fraud and the legal obligations when fraud is suspected. Practically, you will be learning the difference between abuse within the system and fraud, which is a criminal act.

Claims Practitioner in Workers’ Compensation

CPWC (Claims Practitioner in Workers’ Compensation) is a 24 unit certification program developed to meet the needs of emerging claims practitioners. This program offers comprehensive training in foundation principles required to become a certified California WC Claims Adjuster and provides the required 120 classroom hours. Presented at a practical desk level, this curriculum includes learning tools such as case studies and soft skills along with technical information.  Components of the CPWC will also help fulfill certification requirements for California WC Medical Review or Medical Only adjusters.

Lecture Topics Covered

  1. Fraud Statutes
  2. Employer Fraud
  3. Employee Fraud
  4. Provider Fraud
  5. Insurer/Administrator Fraud
  6. Illegal Referrals

Who should attend.

  • Indemnity Workers’ Compensation Claims Adjusters
  • Medical Bill Review Adjusters
  • Medical Only Claims Adjusters
  • TPA / Self Insured Claims Personnel
  • Safety and Risk Management Professionals
  • Agent/Broker Workers’ Compensation Claims Staff

Difference between 3 & 5 hour versions:

  • The Indemnity Track requires the 5 hour version to meet the requirement of 120 hours.
  • The 5 hour version includes Case Studies and homework
  • All other tracks only require the 3 hour version

Key updates in progress.  Please check back soon.