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California Financial License Defense Attorney

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California Department of Insurance License Discipline for PEO Workers Compensation Insurance Fraud

California Department of Insurance License Defense Attorney for PEO Workers Compensation Insurance Fraud

The California Department of Insurance, known as the DOI, vigorously investigates and disciplines Insurance Agents accused of participating in PEO Workers Compensation Insurance Fraud. PEO stands for Professional Employer Organization. California law enforcement agencies heavily prosecute Insurance Agents engaging in PEO Workers Compensation Insurance Fraud. PEO Workers Compensation Insurance Fraud committed by Insurance Agents remains a top enforcement priority for the California Department of Insurance and other law enforcement agencies. Common methods of PEO Workers Compensation Insurance Fraud committed by Insurance Agents include, but are not limited to:

  • Discouraging or Dissuading Employees From Filing Workers Compensation Claims
  • Failure to Maintain Workers Compensation Insurance
  • Failure to Report Employee Injury
  • False Certificate of Insurance (COI)
  • Forged Certificate of Insurance (COI)
  • Issuing Fraudulent Certificate of Insurance (COI)
  • Misclassification of Employees
  • Misclassification of Loss History
  • Underreporting Employees
  • Underreporting Payroll
  • Unlawful Use of Independent Contractors
  • Unlawfully shifting Employees to Other Employers

Consequences of PEO Workers Compensation Insurance Fraud for Insurance Agents can include Insurance License revocation by the California Department of Insurance  and even criminal charges. California Insurance Agents facing allegations related to PEO Workers Compensation Insurance Fraud should contact an experienced California Department of Insurance License Defense Attorney for representation.

California Department of Insurance PEO Workers Compensation Insurance Fraud Investigation Defense Lawyer

The majority of California Department of Insurance PEO Workers Compensation Insurance Fraud Investigations begin with the filing of a consumer Complaint. However, California Department of Insurance Investigations also occur through sting operations and criminal investigations. The California Department of Insurance utilizes non sworn civilian investigators to conduct non criminal investigations. The California Department of Insurance employs sworn Peace Officer Investigators to conduct criminal investigations against Insurance Agents engaged in PEO Workers Compensation Insurance Fraud. The California Department of Insurance works closely with District Attorney’s Offices to combat Insurance Agent assisted PEO Workers Compensation Insurance Fraud. Administrative Law Due Process Rights differ substantially from the Due Process Rights accorded in criminal law.

It is important to have an attorney that understands issues faced by Insurance Agents facing disciplinary action for allegations related to PEO Workers Compensation Insurance Fraud. At the conclusion of a California Department of Insurance investigation, the Department has several options. The Department can choose to close the Complaint. The Department can choose to issue a Citation. The Department can also choose to refer the matter to the California Department of Insurance’s Legal Enforcement Office. The DOI Legal Enforcement Office will determine whether cause exists to file a formal disciplinary Accusation. In PEO Workers Compensation Insurance Fraud cases involving criminal conduct, the Department may refer the case to the District Attorney’s Office for criminal prosecution. If you are an Insurance Agent facing a California Department of Insurance Investigation arising from PEO Workers Compensation Insurance Fraud allegations, contact a California Insurance Agent License Defense Attorney for representation.

California Insurance Agent License PEO Workers Compensation Insurance Fraud Accusation Defense Attorney

A formal Accusation served on a California Insurance Agent serves as notice to an Insurance Agent that the California Department of Insurance intends to revoke the Insurance Agent License. Allegations of PEO Workers Compensation Insurance Fraud committed by Insurance Agents almost always results in the filing of a disciplinary Accusation.

An Accusation is a serious matter that can result in the suspension or revocation of an Insurance Agent License in California. In many cases, it is possible for Insurance Agents to reach a Stipulated Agreement with the DOI Legal Enforcement Office and California Department of Insurance. A Stipulated Agreement is a formal term for a settlement agreement. If a Stipulated Agreement cannot be reached, the parties will proceed to a formal Hearing before the California Office of Administrative Hearings (OAH).

Disciplinary Accusations involving PEO Workers Compensation Insurance Fraud can result in revocation of an Insurance License by the California Department of Insurance. Insurance Agents facing a California Department of Insurance Accusation should contact an experienced California Insurance Agent License Defense Attorney for representation.

California Insurance Agent License Hearing For PEO Workers Compensation Insurance Fraud

The California Office of Administrative Hearings, also known as OAH, maintains several Court Hearing locations. These Court locations are in Los Angeles, Oakland, Sacramento and San Diego. In some instances, Hearings may be held offsite in Bakersfield, Fresno, Orange County, Riverside, San Bernardino, San Francisco, San Jose or Ventura. The Administrative Law Hearing is a formal Hearing before an Administrative Law Judge.

The Administrative Law Judge, or ALJ, will issue a written Proposed Decision approximately 30 days after the Hearing. The California Department of Insurance can adopt, modify or reject the ALJ’s Proposed Decision. The California Department of Insurance’s action is called the Final Decision and Order. There are two main rights of Appeal of a Final Decision and Order. California Government Code § 11521 allows an Insurance Agent to file a Petition for Reconsideration prior to the effective date of the Final Decision and Order. Pursuant to California Code of Civil Procedure § 1094.5, the Insurance Agent can also file a Petition for Writ of Mandamus in Superior Court. A Writ must be filed within 30 days of the effective date of the Final Decision and Order. California Insurance Agents facing a California Department of Insurance Administrative Law Hearing need effective representation from a California Insurance Agent License Defense Lawyer.

California Insurance Agent PEO Workers Compensation Insurance Fraud and Criminal Charges

The California Department of Insurance can discipline Insurance Agents for misconduct that rises to the level of criminal activity, but violates an Administrative Law regulation. The California Department of Insurance disciplinary process is separate from the Criminal Law process. The California Department of Insurance can discipline Insurance Agents for certain criminal convictions. California Department of Insurance License discipline occurs for criminal convictions that are substantially related to the duties, functions and qualifications of an Insurance Agent. All criminal violations of PEO Workers Compensation Insurance Fraud are substantially related to the duties, functions and qualifications of an Insurance Agent.

The California Department of Insurance and other law enforcement agencies often conduct criminal investigations against Insurance Agents for the types of violations described above. In serious criminal cases against Insurance Agents pending in Criminal Court, the California Department of may seek a California Penal Code § 23 Order against the Insurance Agent. A California Penal Code § 23 Order seeks to suspend an Insurance Agent License in Criminal Court. Insurance Agents facing criminal charges and Insurance Agents who are convicted of criminal offenses need an experienced California Insurance Agent License Defense Attorney for representation in disciplinary proceedings before the California Department of Insurance.