California Couple Charged With Insurance Fraud, Identity Theft and Conspiracy

A California couple has been charged for running an insurance fraud scheme where they allegedly stole more than 21 patients’ identities and submitted false insurance claims.

Rebecca Juarez, 39, and Juan Pablo Rodriguez, 31, both of Irvine, were arrested on two counts of conspiracy, 21 counts of medical insurance fraud and 21 counts of identity fraud.

Investigators with the California Department of Insurance began an investigation after several people reported the unauthorized use of their personal information to authorities when they noted charges on their explanation of benefits provided by their health insurers for medical testing and treatment they hadn’t received.

The investigation reportedly showed that Juarez, on behalf of Rodriguez, unlawfully accessed the computerized medical records system of a Mission Viejo medical practice where she worked. Juarez allegedly stole the identifying information of more than 21 patients, which she shared with Rodriguez who had access to a San Jose medical practice’s billing system. Rodriguez reportedly created false medical records for medical testing including COVID tests that were never performed.

Rodriguez submitted the records through the San Jose medical practice’s insurance billing system resulting in the submission of fraudulent insurance claims.

CDI investigators determined the unauthorized billing charges were submitted to various medical insurers between August and November 2023. The total estimated intended loss to the insurance companies exceeded $10,000.

Rodriguez and Juarez were arraigned on a criminal complaint filed in the Orange County Superior Court, and granted conditional releases. The couple are due back in court December 3. The Orange County District Attorney’s Office is prosecuting the case.

Topics California Fraud