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Workers’ Compensation Fraud in Oklahoma
Workers’ compensation fraud in Oklahoma includes, but is not limited to, acts committed with the intent to injure, defraud, or deceive others regarding:
- Claims for payment or benefits under an insurance contract
- Applications for insurance policies
- Insurance policy rating or risk assessments
- Insurance premium payments (regardless of policy issuance)
- Payments made under an insurance contract
- Applications for licenses required by the Oklahoma Insurance Code
- Licenses for health maintenance organizations (HMOs)
- Approvals, permits, or licenses under the Workers’ Compensation Act
- The financial condition of an insurer
- Acquisition of an insurer
- Insurance contracts or Certifications of Non-Coverage under the Workers’ Compensation Act
Acts Constituting Workers’ Compensation Fraud
A person commits workers’ compensation fraud if they:
- Submit or assist in submitting false, fraudulent, incomplete, or misleading statements in support of any claim or application.
- Assist, conspire, or solicit others to submit fraudulent statements.
- Conceal or attempt to conceal material information related to any claim.
- Accept or solicit insurance risks for an insolvent insurer.
- Remove, conceal, or attempt to remove insurer assets or records.
- Divert funds of an insurer related to an insurance contract or business operations.
- Accept benefits in exchange for violating fraud regulations.
- Fail to disclose material changes where disclosure is required.
- Alter, forge, or counterfeit documents with the intent to deceive or mislead.
Note: Lack of a contractual relationship with the insurer is not a defense against allegations of fraud.
Key Definitions
- Contract of Insurance: Includes workers’ compensation insurance and any other legal means of securing compensation.
- Insurer: Any entity engaged in making insurance contracts.
- Person: Any individual or entity, including those directly responsible for fraudulent actions.
- Statement: Any form of communication (written, oral, electronic) used to support claims, including invoices, receipts, medical records, or legal documents.
- Work: Excludes activities yielding only nominal economic gain.
Penalties for Workers’ Compensation Fraud
Any person convicted of workers’ compensation fraud in Oklahoma is guilty of a felony and may face:
- Up to 7 years of imprisonment in the State Penitentiary
- A fine up to $10,000
- Both imprisonment and a fine
For individuals with prior felony convictions related to workers’ compensation fraud, an additional 2-year sentence enhancement applies for each prior conviction.
Fraudulent Insurance Claims
Any person who presents or supports a false or fraudulent claim under an insurance contract for payment of loss is guilty of a felony punishable by:
- Up to 3 years of imprisonment in the State Penitentiary
- A fine up to twice the amount of the aggregated loss
- Both imprisonment and a fine
This includes making, preparing, or subscribing false documentation (e.g., proof of loss, affidavits, surveys) with intent to deceive an insurer.
Sources: 21 O.S. §§ 1662 & 1663 Current as of March 14, 2025. Laws are subject to change at any time! Visit the cited sources for the most current law.