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As part of our website we try to provide as much information as possible for free to the public. In February of 2006 the Illinois Workers' Compensation Act was amended and included authorization of a new fraud prevention unit to investigate charges of fraud in relation to Illinois work injury filings. In 2011, the Act again was amended, including some changes to the laws on workers’ compensation fraud. This page provides an overview. For more information about Illinois Workers' Compensation please visit our main workers' compensation page.

Fraud: An intentional perversion of truth for the purpose of inducing another in reliance upon it to part with some valuable thing belonging to him or to surrender a legal right.

I. Legislative Intent
For the first time, Illinois joined the ranks of other states and established a Fraud Prevention Unit to investigate charges of fraud including uninsured employers and fraudulent claims by employees.

II. Fraud Unit
Section 25.5 establishes a Workers' Compensation Fraud Unit within the Illinois Department of Insurance to address complaints of fraud by both employees and employers. The Fraud Unit is charged with determining the identity of insurance carriers, employers, employees, or other persons or entities that violate the fraud and insurance non-compliance provisions of the Act. The Fraud Unit shall report violations to the Attorney General or the State's Attorney of the county in which the offense allegedly occurred, either of which has the authority to prosecute violations.

A. Reporting instances of Fraud
Any person or entity may report an allegation of insurance non-compliance or fraud to the Fraud Unit. The person or entity reporting an allegation of non-compliance or fraud must identify himself. All reports are kept confidential except to refer an investigation to the Attorney General's office or State's Attorney's office for prosecution. Any person or entity who intentionally makes a false report of fraud or non-compliance to the Fraud Unit is guilty of a class A misdemeanor. Furthermore, it is unlawful for any employer insurance carrier, or service adjustment company to file or threaten to file a report of fraud against an employee because of the exercise by the employee of the rights and remedies under the Act.

A class A misdemeanor is punishable by up to one year in jail and up to a $1,000.00 fine.

B. Punishing Fraud

Those who are found to have committed fraud can be sentenced according to the value of what they obtained or tried to obtain. Violations range from a Class A misdemeanor (for a value of $300 or less) to a Class 1 felony (for a value of more than $100,000). Those convicted will be ordered to pay monetary restitution, which can include the amount that was fraudulently taken, as well as court costs, attorney’s fees and other loss that was caused.

If you have any questions about these laws please let us know.

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