Two separate investigations have resulted in nine arrests on felony insurance fraud charges, including one suspect who was extradited from Arizona and a 10th suspect who was still at large outside the U.S., officials announced earlier in the week.
The cases, stemming from extensive investigations by the Santa Clara County (Calif.) Urban Auto Task Force – comprised of investigators from the California Department of Insurance, Fraud Division (CDI) and the Santa Clara County District Attorney’s Office – revolve around dozens of bogus chiropractic billings for treatment that, in many cases, was never delivered. Both cases will be prosecuted by the Santa Clara District Attorney’s Office.
California Insurance Commissioner John Garamendi and Santa Clara District Attorney George Kennedy announced the arrests at a news conference in Santa Clara this week. Two brothers, Tom Hyungkeun Sim, 33, of Santa Clara and Christopher Hyungkeun Sim, 37, of Cupertino, were arrested in the first case and charged with insurance fraud after a two-year investigation. They operated as chiropractors from St. Thomas Clinic in Santa Clara.
Jung Law Firm attorney Hume Joseph Jung, 35, of El Cerrito, was also arrested and charged with insurance fraud. Jung’s office manager, James Kisik Son, 44, of Fremont was charged with insurance fraud and capping – paying for clients/patients, grand theft and forgery.
The case began in 2003. An undercover officer called the Jung Law Firm and met with James Son, the office manager, regarding a supposed auto accident. The undercover officer told Son he was not injured in the auto accident, but that his vehicle was extensively damaged. Nevertheless, Jung reportedly continued to pursue the personal injury claim, and California Casualty Insurance paid $8,350 to settle it.
Son reportedly also offered to compensate the undercover officer if he referred future clients to Jung Law Firm. Son then referred the undercover officer to the St. Thomas Clinic for treatment, where the undercover officer told the chiropractors, brothers Tom and Christopher Sim, that he was not injured. Regardless, the Sim brothers reportedly continued to treat the undercover officer for the supposed injury and told the undercover officer he could make some money from the claim.
The undercover officer was treated 22 times for a total of $2,850 in chiropractic bills, including treatment that was reportedly never provided. Investigators received assistance from California Casualty Insurance Company on the case.
In the second case, a Santa Clara County Grand Jury returned a 46-count indictment on Sept. 30, 2004, against law firm administrator Teodoro “Ted” Basa Alvarez, 46, of Chandler, Arizona; attorney David Peter Weaver, 67, of San Francisco; law firm bookkeeper Cleopatra “Cleo” Punay Tiong, 79, of Daly City; chiropractor Ghassan Michel Joudy, 41, of San Jose, from Western Chiropractic in San Jose ; chiropractor Carlo Ravara Maravilla, 30, of Vallejo, from Executive Care Center in San Jose; and Edna Bibera Raqueno, 46, of Livermore, from Faith One Auto Body in San Jose. Alvarez was extradited from Arizona on $2 million bail, and Tiong, who is out of the country, was still being sought.
Alvarez, a non-licensed lawyer working out of offices in San Francisco and Millbrae, reportedly conducted a personal injury law practice using the name and state bar number of a non-practicing lawyer, David Weaver. Tiong was Alvarez’s assistant and bookkeeper. Alvarez allegedly paid cappers, such as Edna Raqueno, to refer cases to him.
Alvarez also allegedly sent those clients to chosen chiropractors, such as Carlo Maravilla and Ghassan Joudy, who would pay Alvarez kickbacks for the referrals and who would run up large chiropractic bills, which were subsequently used in sometimes fraudulent insurance claims.
In addition, Alvarez would allegedly steal from his own clients by collecting attorney’s fees when no attorney services were rendered and by embezzling other client funds. Alvarez worked out of offices in San Francisco and Millbrae.
Alvarez reportedly cooperated with Noel Ramayrat, Hector Delao, Rene Fernando and Charles Kavalaris, all of whom also have cases pending in Santa Clara County. In 2000, Alvarez settled claims for a total of $427,518, and again in 2001 for $470,534.
Alvarez was charged with 26 counts of grand theft, 13 counts of paying or receiving consideration from a chiropractor for patient referrals, two counts of conspiracy to commit the unauthorized practice of law, one count of insurance fraud, and one count of capping. Weaver was charged with 21 counts of grand theft and one count of conspiracy. Tiong was charged with 26 counts of grand theft and two counts of conspiracy. Maravilla was charged with nine counts of capping and three counts of insurance Fraud. Joudy was charged with four counts of capping, and Raqueno was charged with one count of capping.
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