Living a Life of Lies

Following a joint investigation by the CDI Fraud Division and the California Department of Justice, Jessica Rodriquez of Sacramento was arrested and is being charged with three counts of insurance fraud, two counts of false claims to a Public Board and 11 counts of providing false financial statements.

The 48-year-old woman used 36 aliases, five different Social Security numbers and four different California drivers' license numbers-many of which were used in an attempt to conceal the amount and frequency of her claims, according to investigators.

The suspect allegedly made one house fire claim, five theft claims, seven auto claims, five water damage claims and two workers' comp claims. Investigators said that Rodriquez used fraudulent documents to show relationships with fictitious businesses and professionals to advance her phony claims.

Rodriquez allegedly submitted 25 claims to ten different companies since 1995. In those claims, she reported $490,550 in losses and was paid a total of $470,015.

Sounds Like a Bad Case of Regret

Following a three-month investigation, Cecil Nuncio Gloria of Stockton surrendered to authorities at the San Joaquin County Courthouse and pled guilty to one misdemeanor count of insurance fraud.

According to investigators, the 24-year-old man filed a claim with 21st Century Insurance Company on June 21, 1999, in the amount of $249.70. He alleged that four tires on his 1994 Nissan Pathfinder had been vandalized while the vehicle was parked in front of his home. Two days later, Gloria contacted 21st Century to report that the stereo in his vehicle had been stolen during the vandalism. To back up his claim, the suspect submitted a receipt from The Stereo Zone in the amount of $1,756.85.

During a routine claims check, 21st Century discovered that The Stereo Zone did not sell or install the stereo, indicating that it was now time to refer the case to the CDI Fraud Division. Investigators did their research and found The Stereo Zone deals strictly with cellular telephones and pager sales.

Gloria admitted that he found The Stereo Zone receipt and filled in the false stereo information himself. He also told investigators that he wanted to drop his claim. Due to the false information, 21st Century denied Gloria's claim.

Repo Man Pays an Unwelcome Visit

Rickki Chantelle Saulsby of Citrus Heights was arrested and booked into Sacramento County Jail on two felony counts of insurance fraud.

According to CDI fraud investigators, Saulsby submitted a claim to 21st Century Casualty Insurance Company for theft of her 1993 Chevy Lumina. In her claim, Saulsby alleged that on July 13, 1999, her vehicle-valued at $4,700-had been stolen from the parking lot of Pacific Avenue Bowl in Stockton.

Investigators contacted the lienholder to Saulsby's vehicle and were informed that Saulsby had been advised through phone calls and fax that her vehicle was going to be repossessed due to non-payment.

During a Sept. 29, 1999, deposition, Saulsby denied that her vehicle had been repossessed. Two days later, during an Oct. 1, 1999, deposition, Saulsby confessed that on July 13, 1999, she discovered her vehicle was missing from her apartment parking space. Saulsby called the Citrus Heights Police Department to file a report and was told that her vehicle had been repossessed. She claimed that her boyfriend had convinced her to file the false claim.

As a result of Saulsby's false statements, 21st Century Casualty Insurance Company denied her claim.

It Takes One to Know One

Tina Marie Gains of Elk Grove was arrested and charged with five felony counts of insurance fraud and one felony count of unemployment benefits fraud. The 42-year-old woman allegedly made false statements in order to obtain workers' comp and unemployment benefits. At the time of her arrest, Gains was working as a workers' comp claims examiner for ATI Claims Services of Oakland.

According to CDI fraud investigators, on Aug. 7, 1996, Gains was terminated from her job with Professional Search of Oakland. Roughly two weeks later, she submitted a workers' comp claim to her former employer's insurer, State Compensation Insurance Fund (SCIF). In her claim, Gains alleged she suffered an industrial injury to her wrists, hands, the left side of her neck, her left shoulder and her upper left back while working for Professional Search. SCIF awarded Gains temporary disability payments.

Investigators learned that Gains submitted forms to the Employment Development Department for disability benefits, claiming that she was not employed. Yet employment records revealed that Gains continued to work as a workers' comp claims examiner and/or a data processor during the times she claimed she was not working.

As a result of Gains' fraudulent activity, SCIF paid out $28,840 on this claim.

Phone-y Workers' Comp Claim

Paul C. Caldwell of Marina Del Rey was arraigned on 14 felony counts of insurance fraud. The 48-year-old man allegedly made false statements on a workers' comp claim.

According to CDI fraud investigators, on Feb. 28, 1996, while Caldwell was employed by AT&T as a sales manager, he reportedly tripped and fell on a curb in Santa Monica, injuring his left knee, right arm, right ankle and lower back. As a result, Caldwell filed a claim for workers' comp benefits with AT&T's insurer, Kemper Insurance.

The investigation revealed that Caldwell had filed two previous workers' comp claims involving the same body parts. On May 1, 1992, while working for PacTel, Caldwell slipped on oil in a parking lot

and fell, injuring his left knee and lower back. He settled this claim with PacTel's third-party administrator for $22,500.

Two years later, on May 17, 1994, while working for Phoenix Network, Caldwell claimed he slipped and fell on some stairs, injuring his left knee and right elbow. He settled with Phoenix Network's insurer, the National American Insurance Company, for $55,000.

During a deposition and in statements to several doctors, Caldwell claimed he had no prior injuries and that he had undergone no previous surgeries to his right arm. Contrary to his claims, investigators found that Caldwell had undergone surgery in the ulnar nerve in his right elbow. In fact, he had a scar as a result of the surgery.

Due to Caldwell's misrepresentations, the workers' comp claim cost Kemper a total of $69,020.