Phone-y Workers’ Comp Claim

Paul C. Caldwell of Marina Del Rey was arraigned on 14 felony counts of insurance fraud. The 48-year-old man allegedly made false statements on a workers’ comp claim.

According to CDI fraud investigators, on Feb. 28, 1996, while Caldwell was employed by AT&T as a sales manager, he reportedly tripped and fell on a curb in Santa Monica, injuring his left knee, right arm, right ankle and lower back. As a result, Caldwell filed a claim for workers’ comp benefits with AT&T’s insurer, Kemper Insurance.

The investigation revealed that Caldwell had filed two previous workers’ comp claims involving the same body parts. On May 1, 1992, while working for PacTel, Caldwell slipped on oil in a parking lot
and fell, injuring his left knee and lower back. He settled this claim with PacTel’s third-party administrator for $22,500.

Two years later, on May 17, 1994, while working for Phoenix Network, Caldwell claimed he slipped and fell on some stairs, injuring his left knee and right elbow. He settled with Phoenix Network’s insurer, the National American Insurance Company, for $55,000.

During a deposition and in statements to several doctors, Caldwell claimed he had no prior injuries and that he had undergone no previous surgeries to his right arm. Contrary to his claims, investigators found that Caldwell had undergone surgery in the ulnar nerve in his right elbow. In fact, he had a scar as a result of the surgery.

Due to Caldwell’s misrepresentations, the workers’ comp claim cost Kemper a total of $69,020.

Topics Workers' Compensation