View this article online: https://www.insurancejournal.com/magazines/mag-features/2005/03/21/53379.htm

From the Fraud Wire … Outrageous Stories Hit the Headlines

  • A California Department of Insurance Fraud Division investigation allegedly caught a former Folsom, Calif., prison correctional officer on surveillance video riding a jet ski, using a water slide, and doing back-flips off the jet ski while supposedly injured on a workers’ comp claim.

    June Ann Lucena, 41, of Placerville, Calif., was arrested and booked in December 2004 into the Sacramento County jail on $10,000 bail and charged with one count of attempted perjury and one count of issuing a false statement to fraudulently obtain compensation. If convicted, Lucena faces up to five years in state prison and a maximum fine of $150,000.

    The State Compensation Insurance Fund has paid $170,309 on Lucena’s claim, opened in April 1999 when the woman was reported injured after falling from a tower in the prison, reported the CDI Fraud Division. According to the department, she complained of “constant” pain in her back, head, neck, shoulder and leg. She resigned from the Department of Correction in November 2003, and continued to receive medical retirement benefits.

  • Five people in a network of four temporary employment agencies dodged workers’ comp premiums and taxes by paying more than $30 million in employee salaries in cash under the table, authorities said. The operators of the Massachusetts firms created false payroll statements for the workers’ comp insurers and doctored federal tax returns to reflect the lower payouts, authorities allege.
  • A former U.S. Postal worker faked his injuries to collect more than $406,000 in workers’ comp money during a 10-year fraud spree. Marshall Galex claimed he couldn’t work after a vehicle accident on the job. But suspicious Postal inspectors tailed the Dingmans Ferry, Pa., man and videotaped him splitting wood, operating a log splitter and installing road signs. The former bulk-mail clerk was convicted in federal court.
  • A Chicago, Ill. workers’ comp lawyer tried to steal an $80,000 insurance payment from his mentally unstable client. The victim had hired lawyer Steven J. Della Rose to handle a workers’ comp claim against the Chicago Housing Authority after injuring his shoulder. Della Rose received the check then had a crony inside the Illinois secretary of state’s office issue a fake state ID card with the victim’s name but the photo of Della Rose’s business partner. The two men used the fake ID to cash the check.
  • A Texas man hurt his shoulder so badly while working for an employee-leasing firm that he had to leave work and collect workers’ comp money until a suspicious Texas Mutual Insurance Company videotaped him moving a 500-pound entertainment center around. Thomas O’Laughlin was perfectly healthy, two doctors agreed at the trial. He pleaded no contest and awaits sentencing.

    • The Coalition Against Insurance Fraud contributed to this report.