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Gilroy, California, is the Garlic Capital of the World … which has absolutely nothing to do with the fact that Gabriela Gomez slipped in a shower she was cleaning while employed as a Merry Maid. Gomez took about six weeks off for the injury to heal, then returned to her job for another two years. But then she had a sudden return of the pain and again claimed disability. But as is so often the case, garlic withstanding, investigators learned that she was actively employed at another job while she was collecting disability checks from Merry Maid’s insurer. If convicted, Gomez could be spending five years … cleaning a jail cell.
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Pasadena, California Gill Onions truck driver Gary Mourett messed with PAULA Insurance Company. Not smart! Mourett claimed a work-related injury to his left elbow, right wrist and back. Not so. Now convicted by a jury on two felony counts of workers’ compensation fraud, he faces a prison sentence and a hefty fine. Not bad.
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Lynn, Massachusetts And here’s one with a twist. David Vining owned a rubbish hauling company. Michael Bonacorso Jr. owned an insurance agency. Vining was a favored customer of Bonacorso and received some rather special assistance on a problem involving workers’ compensation premiums. In short, Vining’s company had a problem with accident frequency and the high rates reflected that fact. So, with the help of his good buddy agent, Bonacorso, Vining set up some shell companies in order to avoid the premium surcharges.
Investigators determined that the insurance companies lost between $120,000 and $200,000 in premium because of the misrepresentation. Vining was charged with conspiracy, mail fraud and wire fraud in connection with the scheme, and he pleaded guilty to those charges. It took an additional two years to bring Bonacorso to justice and impose a fine ($40,000) for the part he played in the scam. The FBI and the Massachusetts Fraud Bureau cooperated in this investigation.
* Sacramento, California In 1993, Teresa Marez-Ortiz tripped on an electrical cord and fell. The accident, which occurred during an office remodel, caused injuries to the back of her head, right shoulder and lower back, right knee and foot. She was seen during subsequent years by numerous doctors, both medical and psychiatric. She even spent time with a psychologist. And, through it all, the State Compensation Insurance Fund paid and paid and paid. Within a year of HER accident, hubby Lucas Ortiz also filed a claim with SCIF alleging head, neck and back injuries were sustained when HE fell at work. SHE would show up at doctor visits in a wheelchair, complaining of constant pain, inability to walk, feelings of depression and thought of suicide. At the same time, HE was depressed, unable to venture outside of the family home and would remain in his room at the sound of a barking dog. SCIF paid in excess of $120,000 to the couple, and HE and SHE each demanded $450,000 to settle their respective claims. A thorough investigation, however, told quite another story. Both HE and SHE were observed out and about, shopping, walking and possibly even employed. And HE forgot to mention a previous workers’ compensation claim/settlement in the amount of $26,000. Now both HE and SHE have both been arrested and each has been charged with six felony counts of insurance fraud.
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