Division of Insurance coverage investigation Leads to a quantity of felony counts of insurance fraud and perjury
August 3, 2021 – L. a. — Frank Simplicio, 45, of Porter Ranch, was arraigned on a quantity of felony counts of insurance fraud and perjury. A Division of Insurance coverage investigation revealed Simplicio allegedly declareed to be too injured to work So as To collect over $50,000 in incapacity funds from one employer’s insurance agency whereas ilauthorizedly working for completely different employers.
On Might 2, 2017, Simplicio, whereas working as a greensman, filed a declare Collectively with his employer’s insurance agency stating cumulative trauma to his neck and again. He additionally declareed the job led to his diabetes, inner accidents and sleep disturbance. He reported the dates of his cumulative trauma accidents as July 19, 1996 by way of Might 29, 2015. The declare by no meanstheless was filed two years after his alleged accidents.
The investigation found that Simplicio was paid Short-term Complete Disability funds from February 20, 2018 by way of September 19, 2018, totaling $32,051. He additionally acquired Everlasting Disability funds from September 20, 2018 by way of December 13, 2019, totaling $18,610.
In a deposition, Simplicio said he was a landscaper, however he had not labored As a Outcome of the date of his damage. However, surveillance footage in October 2018 and February 2019 revealed Simplicio was actively working as a landscaper. A search warrant was later issued for Simplicio’s Checking account data, which found he collected checks from consumers from June 2015 by way of December 2019, totaling over $450,000. This Does not embrace potential income from direct deposits by way of his account.
When informed what the investigation found, the Licensed Health worker who dealt with Simplicio’s declare said Simplicio lied and if That they had acknowledged about his talents and concurrent employment They Might have by no means put him on Short-term Complete Disability. Simplicio’s alleged actions Outcomeed in him receiving $50,661 in undeserved incapacity funds. The complete loss for the insurance agency On this case was over $100,000, Which incorporates pointless medical, investigative, and authorized prices.
Simplicio self-surrendered to The l. a. Superior Courthouse and was arraigned on July 29, 2021. The Los Angeles County District Lawyer’s Office is prosecuting this case.
The California Division of Insurance coverage, established in 1868, is The Most very important shopper safety agency in California. Insurers collect $340 billion in premiums yearly in California. Since 2011 the California Division of Insurance coverage acquired Greater than 1,000,000 calls from consumers and helped recuperate over $469 million in declares and premiums. Please go to the Division of Insurance coverage internet website at www.insurance.ca.gov. Non-media inquiries Ought to be directed to The client Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.
Supply: CA. Dept. of Insurance coverage