Ex-NFL Player Charged with WC Insurance Fraud

6235447929_53d085c8a4 Interesting read on workerscompensation.com, former NY Giants player Marcus Buckley, who played 7 season with them claimed to have multiple stress injuries has been charged with WC fraud.  He prepared fictious bills and statements to defraud a TPA to the tune of $1.5 million dollars with some inside help.

I bet all parties involved wish it was only a 15-yard penalty and they could replay the down inside of the 20 years maximum penalty they are now facing.  The real victim here is PMA Insurance (the TPA was managing claims for PMA) for the money that was paid out.

What's your take? Continue the discussion with others over at the WCInsights LinkedIn Group.
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  1. The workerscompensation.com article seems to be somewhat more accurate than what I read on BusinessInsurance.com today… The BI article portrays GB as the victim in this saying that the bad guys “schemed to defraud GB out of $1.5 million” in fake bills. Clearly if these charges prove accurate, the ultimate victims are PMA who paid-out over a million to these frausters, and the NY Giants who likely took a signific hit in premium as a result of this. This case once again points to how important it is to have very tight integration of technologies and workflows between payers and all vendors – including TPAs. GB is an outstanding company with top-notch people and this event represents a very tiny fraction of the business they manage, but payers need 360-degree granular level claim detail so fraud can be detected sooner and more consistently. Also so deeper insight into the business is gained allowing for superior decison making at every level of the enterprise.

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