What Really Hurts'

Susan Jeanette Hobson, 40, surrendered to investigators from the California Department of Insurance (CDI) on three felony counts of insurance fraud and one felony count of perjury.

In February 1996, the Sacramento woman allegedly tripped in the parking lot of her employer, Catholic Health Workers Foundation, and claimed to have injured her left ankle.

Hobson then filed a claim with Applied Risk Management. In December 1996, she filed a second claim against American Multiline Corporation and Reliance Insurance Company for a cumulative trauma injury to her left arm as a result of prolonged work at her computer.

Hobson told treating doctors that she could not use her hands, stand or walk, for long periods of time as a result of her injuries. She reiterated these statements in a February 1998 deposition. Investigators videotaped Hobson between December 1997 and February 1998 and found that she was in fact able to use her hands, stand and walk.

As a result of the false claim and misrepresentations, Applied Risk Management and Reliance Insurance Company paid Hobson $21,600 in workers' comp benefits.

Found Fudging Receipts

After surrendering to investigators last month, Victor Tafoya, 58, of Sacramento was arrested on one felony count of insurance fraud and one felony count of perjury.

In October 1998, Tafoya's residence caught fire due to an improperly installed pellet stove. After the fire, he filed a claim for the loss. Tafoya's insurance policy allowed for replacement coverage, but required that he pay for work done and then submit receipts for reimbursement.

According to investigators, an employee of the insurance company thought that a receipt may have been altered. As a result, the company that issued the receipt was contacted, uncovering that the amount on the receipt had, in fact, been changed. Further investigation revealed that Tafoya had allegedly altered nine receipts from companies who performed construction work on his home. The amount of the altered receipts totaled $17,050 to which Tafoya was not entitled.

Touchup Needed on This Work of Art

Marco Anthony Ambroselli, 33, of Sacramento surrendered to authorities after a warrant for his arrest was issued for one felony count of insurance fraud.

According to investigators from the CDI Criminal Investigations Branch, Traveler's Insurance Company was paying claims for damage to personal property due to mold infestation at the Fairways Apartments in Citrus Heights, Calif., in the winter of 1998. Ambroselli, a resident of the apartment complex, submitted an estimate receipt for repairing an alleged 16th Century painting valued at $80,000.

In October 1998, Ambroselli informed Traveler's that the painting had begun repair at A-Art's Antiques in Folsom, Calif., and that the repair was estimated between $2,000 and $2,500. Since Ambroselli did not have a receipt to prove the entire cost of repair, Traveler's paid him $2,000 rather than $2,500. In November 1998, he submitted a letter to the insurance company, allegedly by the owner of A-Art's Antiques, requesting an additional $500 to complete the repair.

Investigators dug deeper, and interviewed the owner of A-Art's Antiques. The owner admitted to providing an estimate to the Sacramento man, but he had never repaired the painting or signed for the additional cost of repair.

Traveler's Insurance paid Ambroselli $58,541.72 for alleged property damage. The case remains open to further investigation.

Crash Landing for This Pilot

Paul Franklin Ostrove of Hermosa Beach was sentenced to six months in jail for insurance fraud after making false statements about his qualifications to pilot an aircraft when filing a claim in connection with the crash landing in August 1998 at Daniel Webster Junior High School in Los Angeles. Three passengers were injured when the plane ran out of fuel.

The insurance policy on the plane stated that coverage was dependent on pilots meeting all Federal Aviation Administration (FAA) certification requirements. According to CDI investigators, Ostrove did not meet all of the requirements at the time of the crash. The FAA later revoked his pilot's license, but Avemco Insurance paid more than $250,000 on the claim.

In addition to the jail sentence, the 34-year-old man was ordered to pay more than $212,000 in restitution and serve five years probation. Earlier this year, Ostrove pleaded no contest to a grand theft charge.

Cruisin' for a Bruisin'

Insurance broker Shahin Sean Pelaseyed, 46, of North Hollywood pled no contest to one count of grand theft of insurance premiums in a Van Nuys Superior Court.

Pelaseyed was originally charged with five felony counts of grand theft of insurance premiums, which was in violation of probation placed upon him after a 1997 theft conviction. According to CDI investigators, Pelaseyed operated Sean Pelaseyed Insurance Services, providing commercial policies to trucking companies in Northern and Southern California. From January 1999 to August 1999, the broker collected at least $28,000 from five trucking companies for commercial policies, yet he sent only partial payments to some insurance companies and no payments to others.