News: 2010 Press Release
For Release: June 2, 2010
Media Calls Only: 916-492-3566
Commissioner Poizner Announces Arrest of Former City and County of San Francisco Claims Examiner for Fraudulently Spending Public Money
CORRECTED: The suspect is a former employee of San Francisco City and County, not a former employee of the San Francisco Unified School District.
Insurance Commissioner Steve Poizner announced today the arrest of Leticia James Coral, aka Letty James Diaz, 56, of Pacifica, on charges of fraudulently disbursing public money. The former City and County of San Francisco Claims Examiner self-surrendered to San Francisco County Jail on May 31. Bail was set at $75,000.
"Wasting public money to line your own pockets is wrong and will not be tolerated in California," said Commissioner Poizner. "If you attempt to scam the public, you will not get away with it."
The CDI investigation revealed that during the course of her employment as a Claims Examiner with the City and County of San Francisco, Coral allegedly gifted more than $76,000 in public funds to an injured school district employee. Coral purportedly gifted the funds while knowing that the workers' compensation claim was not worth the $85,000 in permanent disability advances that she issued the injured worker. A qualified medical exam determined the injured worker was 17 percent disabled, which meant the injured worker was entitled to $9,320 in permanent disability payments.
It is alleged that Coral issued these huge advances, having arranged for the injured worker to loan or give Coral half of the money issued. These large permanent disability advances began in 1999 and ended in 2003.
In October 2009, after reviewing this particular claim file and suspecting fraud, Tristar Risk Management referred this case to the California Department of Insurance for investigation. Tristar is a third party administrator of workers' compensation claims. The company was hired to administer claims for the San Francisco Unified School District in 2004. The San Francisco Unified School District contracted the and City and County of San Francisco to administer the District's workers' compensation claims prior to Tristar's assignment.
In July 2008, Tristar told the injured worker that she was overpaid by approximately $76,000 in permanent disability. The injured worker then advised Tristar that she loaned half of the permanent disability advances to Coral. It is alleged that Coral had asked the injured worker to borrow half of the payments. The injured worker claimed she was unaware of the large discrepancy between what she was paid and the claim's actual worth. According to the worker, she would meet Coral at a bank, cash the permanent disability check and give Coral half of the cash. The injured worker tried to get in touch with Coral several times in an attempt to get the money back that had been loaned to Coral. Coral never called the injured worker back and never paid any money back to her.
Commissioner Poizner oversees sixteen CDI Enforcement Branch regional offices throughout the state. Nearly 2,800 insurance fraud-related arrests have been made by CDI since Commissioner Poizner took office in 2007 - more arrests than have been made during any other three year period, under any previous insurance commissioner.
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