Wisconsin's Insurance Commissioner Issues Forfeiture of
$33,000 in Action to Address Insurance Fraud
Madison, Wis. — The Wisconsin Office of the Commissioner of Insurance (OCI) has announced the issuance of the agency's first forfeiture related to
insurance fraud under
Wis. Stat. § 601.41 (12).
Governor Tony Evers created the
Joint Enforcement Task Force on Payroll Fraud and Worker Misclassification in 2019 to propose regulatory changes to better investigate potential law violations and improve enforcement where violations have occurred. The Task Force's
2020 Report recommended creating an Interagency Coordinated Enforcement Team (IACET) which was composed of OCI, Department of Workforce Development, Department of Revenue, Department of Justice, and Department of Financial Institutions. The IACET was tasked with meeting regularly to develop recommendations targeting insurance fraud and other issues. The group identified the need to strengthen the agencies' abilities to identify and prosecute perpetrators.
“I was proud to serve on Governor Evers' Task Force to consider the impact of insurance fraud and identify opportunities to address it," said Insurance Commissioner Nathan Houdek. “Insurance fraud costs billions every year, with the average American family paying between $750-$1,000 in increased premiums due to fraud perpetrated by others. Thanks to bipartisan support from the state legislature and Governor Evers, we've been able to put new authority and resources in place to take action."
In 2023, Governor Evers signed the state budget, 2023 Wisconsin Act 19, which created new OCI authority when an investigation identifies an act of insurance fraud.
Wis. Stat. § 601.41 (12) defines insurance fraud as “knowingly presenting a false or fraudulent claim" or “presenting false information in an application for insurance." The 2023-25 state budget also created an attorney position for OCI tasked with investigating alleged fraudulent insurance acts under this new authority.
“OCI has built a fraud unit from the ground up thanks to the hard work of Kelly Altschul, our attorney leading this effort," said Commissioner Houdek. “Kelly has developed a new system for receiving complaints, tips, and referrals from other entities regarding potential insurance fraud which led us to issuing our first forfeiture."
Sawan Kumar owns a transportation service in the Milwaukee area but represented his business as a clerical dispatch business on his application to his workers compensation insurer. As a result, he paid much lower insurance premiums than he should have been. Between 2016 and 2022, he continued to make various misrepresentations to his insurer that resulted in $101,690 underpayments. OCI issued a fraud forfeiture under our new statutory authority resulting in a total of $33,000. Forfeitures like these go to the state's Common School Fund, which provides books, computers, and other library materials to schools across Wisconsin.
You can report insurance fraud
online or email the fraud unit to ask questions or share concerns at ocifraud@wisconsin.gov.