Department Of Insurance Busted $25-Million WC Fraud

Department of Insurance detectives have arrested nine people in connection with a serious case of workers’ compensation fraud, which caused financial damage to more than 200 insurance carriers and self-insured employers.

A company called G&G Interpreting Services, run by siblings Francisco Javier Gomez, Jr. and Angela Rehmann, issued fraudulent bills for non-existent services of translating Spanish. The total worth of the fraud has been estimated at $24.9 million.

G&G Interpreting worked with clinics and was supposed to mediate between injured workers of Latino origin seeking medical care and the healthcare professionals for Personal Injury and After Work Injury’s. However, the investigation revealed that the majority of staff in the clinics were Spanish speakers, while in others over 10 doctors spoke Spanish fluently. Needless to say, services of an interpreter weren’t necessary.

The medical institutions with which G&G Interpreting allegedly worked are located throughout Southern California and include the counties of LA and San Diego, Santa Barbara, Riverside, Orange, San Bernardino and Ventura.

The detectives have established that the alleged services were delivered on about 83,000 occasions. What is interesting is that it turns out the interpreters worked over 12 hours a day, which is more than the clinics were open. There is also the fact that services worth $400,000 were delivered by an interpreter who was ubiquitously in state prison doing a sentence.

Insurance Commissioner Dave Jones said that there is a wide-spread misconception that defrauding the workers’ compensation system is a crime without a victim, because in the end everyone has to pay.

In 1991 the Department of Insurance founded Fraud Assessment Commission that established how much was to be funded through employer assessment for enforcement and prosecution costs. It was in that year that workers’ compensation fraud was given the status of felony.

In October 2015 Jones was given grants in the amount of almost $35 million to fight insurance fraud. The funds were allocated to the district attorney offices in 42 California counties. In this case, the investigation was run by Dept. of Insurance detectives and supported by Riverside and San Bernardino district attorney offices, as well as California Highway Patrol. The suspects will be prosecuted by Los Angeles County district attorney office.

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