Mother Arrested in "Stuffed Passenger" Accident Case

Ebony Kirk, of Sacramento, was arrested for falsely reporting herself as a passenger in an auto accident that occurred on Aug. 19, 2003. She was charged with four felony counts of insurance fraud and could face up to five years in state prison and a maximum fine of $150,000.

The case, being prosecuted by the Sacramento County District Attorney's office, was investigated by the California Department of Insurance Fraud Division as part of an ongoing statewide investigation of insurance fraud and false insurance claims filing.

Kirk allegedly reported to 21st Century Insurance that she had received injuries resulting from the accident and began treatment with a doctor. Her insurance company later settled Kirk's claim, paying her $2,400 in medical benefits. After further investigation, Kirk admitted in a recorded statement to fraud investigators that she was a "stuffed passenger," a fictitious passenger in the vehicle at the time of the accident.

Calif. Chiropractor, Associates Nabbed in $10M Workers' Comp Scam

A Modesto, Calif. chiropractor and two employees were arrested on charges that they repeatedly billed for services that were unnecessary or never rendered from 1996 through 2004, potentially costing insurers more than $10 million.

Chiropractor Wilmer Dorado Origel, of Modesto, is the owner and operator of the businesses involved in the alleged fraud. His associates, Rebecca Marie Benedict and Robin Elaine Barney were also taken into custody. All three were charged with multiple felony counts, including insurance fraud, grand theft and practicing medicine without certification.

Investigators believe that Origel conspired with his associates to illegally over-bill workers' compensation and auto insurance carriers for services never rendered, services not medically necessary, and for services beyond the scope of their licensed authority to perform. Origel owned and controlled Med-1 Medical Center P.C., and Unique Healthcare Management Inc., both based in Modesto.

Med-1 Medical Center has had clinics located at various times in Modesto, Stockton, Sacramento and Turlock. Unique Healthcare Management Inc. is a medical billing company which performed the billing and other accounting services for Med-1 Medical Center and various other medical provider businesses that are believed associated with Origel. Unique Healthcare Management Inc. is believed to have been solely owned and operated by Origel and managed with the assistance of administrator Robin Barney and accounting manager Rebecca Benedict.

Significant assistance has reportedly been given to police authorities by investigators with St. Paul Traveler's Insurance, State Compensation Insurance Fund, Progressive Insurance Co., State Farm Insurance Co., Zenith Insurance Co. and Republic Indemnity Insurance Co. The National Insurance Crime Bureau also provided assistance with the investigation.

Four Arrested for Workers' Comp Fraud

Joint investigations by the CDI's Fraud Division and the Imperial County District Attorney's Office have resulted in the felony arrests of four suspects for multiple counts of workers' comp insurance fraud.

Each of the four suspects, if found guilty, faces up to five years in state prison and/or a maximum fine of $50,000.

Most recently, Roberto Herrera of Calexico, Calif., was arrested Dec. 20, 2004. While employed as a meat cutter at Brawley Beef Company, Herrera allegedly made false statements to his workers' comp physician when he claimed he was unable to do his customary work due to the extent of his injuries. He also allegedly made false statements in his workers' comp claim by stating that he had no earnings during his claim period. The resulting loss to the insurance carrier was $13,066.

Three earlier arrests include Juan Ramirez of El Centro; Joe Diaz of Brawley; and Marco Armenta of Calexico.

Ramirez, a tendon puller while em-ployed at Brawley Beef Co., was arrested on July 2, 2004, after investigators alleged that he was working for two other employers while collecting workers' comp benefits. Ramirez originally claimed he injured his wrists while working for Brawley Beef Co.

Diaz, a rib-saw operator while employed at Brawley Beef Co., was arrested on June 24, 2004, after investigators discovered an allegedly fraudulent workers' comp claim for a back injury. Diaz allegedly failed to let the medical providers know that he had at least four previous workers' comp claims for back injuries. In addition, the investigation revealed that Diaz had a 2000 conviction for workers' comp fraud and is currently on probation. His sentence could be enhanced if found guilty.

Armenta was arrested on June 18, 2004, for allegedly filing a false claim. He claimed that a pipe fell on him while performing court-ordered community service for the City of Calexico. Investigators discovered evidence indicating this was a false claim.