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Following a three-year joint undercover investigation by the California Insurance Fraud Department and the Santa Clara County District Attorney’s Office, five members of an insurance fraud ring, including a capper, an attorney, two chiropractors and an office assistant, were arrested for their alleged involvement infilling fraudulent insurance claims and for billing insurance companies for medical services not rendered.
Those arrested include Kenneth Kwan of San Jose, who was the capper and manager of the fraud ring; the attorney of the group, Arthur Grams, who was arrested at his office; chiropractors Sandy Yung Luu Nguyen of San Jose and John Stiga of Santa Cruz; and Stiga’s office assistant, Mai Thanh Nguyen of San Jose. Each member of the fraud ring will be charged with various counts of felony insurance fraud. A total of 14 charges have been filed against the group, with Kwan receiving six of those counts.
During the investigation, undercover investigators from the DOI posed as accident victims on two separate occasions. The investigators consulted with Kwan at a law office in order to make the insurance claims. Although the outward appearance was that Kwan worked for the law office, in practice Kwan managed the insurance claims, with the attorney acting as the front.
Kwan sent one investigator to Advanced Health Care, a clinic operated by Stiga, and referred the second investigator to Sunshine Chiropractic, a clinic run by Sandy Nguyen. Subsequently, both clinics submitted bills for treatments which the undercover investigators never received. The law office then used those bills to make fraudulent claims to the insurance companies. The law office even advised one undercover officer that the more treatments he received from the chiropractor, the more money he would be able to collect from the insurance company. The law office also paid the undercover investigators a referral fee for sending accident victims to their office.
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