View this article online: https://www.claimsjournal.com/news/west/2005/02/16/51560.htm
A Downey law office administrator, Rebecca M. Perez, of Riverside, and two Downey chiropractors, Dr. Raymond T. Oca, of Cypress, and Dr. Paul J. Lopez, of Huntington Beach, surrendered themselves to the Los Angeles County Superior Court after being charged with more than 40 counts of Illegal referrals, insurance fraud, workers’ compensation insurance fraud, disability insurance fraud and attempted grand theft.
The arrests were the result of Operation Pay Me, an investigation by the California Department of Insurance’s Fraud Division (CDI) with assistance from the National Insurance Crime Bureau and Preferred Personnel, a temporary employment agency based in the Los Angeles area.
The L.A. County District Attorney’s Workers’ Compensation Fraud Division is prosecuting the case. If convicted on all counts, Perez could face a maximum of five years in state prison. Likewise, Oca and Lopez each could face a maximum of three years in state prison.
The case began in January 2002 when employees of Preferred Personnel reported to CDI that their Downey office was approached by Perez with a dubious proposal. Allegedly, Perez offered to pay Preferred Personnel staff $500-$600 for each workers’ compensation case referred to various chiropractors on a list supplied by Perez.
Later that month, Perez offered the same deal to an undercover CDI investigator introduced to Perez as a Preferred Personnel employee who handled all workers’ comp claims. Perez also provided the investigator with $500 “up front” for a future referral.
Additionally, Perez reportedly told the investigator that she handled bodily injury cases involving auto accidents and would pay $1,000 for each person the supposed employee referred to her.
Over the next six months, CDI investigators posing as claimants were referred to Oca and Lopez, who then treated non-existent injuries. The chiropractors were allegedly aware that the “claimants” were concurrently working and receiving treatments. Furthermore, Oca and Lopez alegedly placed the undercover investigators on temporary total disability, even assisting with completing a state Employment Development Department “Claim for Disability Insurance Benefits” application. Had the undercover investigators been real claimants, this fraud would have been approximately $10,000.
Perez also allegedly submitted a false insurance claim for an auto accident that never occurred.