Insurance Commissioner Dave Jones Announces Arrest of Southern California Man for Insurance Fraud
News: 2012 Press Release
Insurance Commissioner Dave Jones today announced that Julio Santiago, 53, of Rowland Heights, has been arrested on two felony counts for violating Insurance Code Section 1871.4 (a) (1), making a knowingly false or fraudulent statement to obtain compensation, and two felony counts for violating Insurance Code Section 1871.4 (a) (2), presenting false or fraudulent written material to obtain compensation, and one felony count for violating Penal Code Section 487 (a) Grand Theft.
According to investigators, on April 9, 2009, Santiago allegedly suffered an industrial injury while working as a security guard for the Hacienda La Puente Unified School District and later submitted a workers' compensation claim to Intercare Insurance Services. Intercare conducted an investigation on May 21, 2009 and it was revealed that Santiago was working as a security guard for another employer while collecting workers' compensation benefits. Intercare referred this claim to the California Department of Insurance (CDI) Fraud Division for further investigation.
CDI Fraud Division investigators found that Santiago was knowingly working as a security guard for another employer during the period June 2009 to May 2012 and while doing so he earned $29,750 in income while also collecting workers' compensation benefits for a work-related injury. The investigation further revealed that during the period of June 13, 2009 and February 17, 2010, Santiago received Temporary Total Disability (TTD) benefits in the amount of $13,606.86 from Intercare because he alleged he could not work as a security guard due to his work-related injury.
The investigation revealed that Santiago knowingly failed to disclose to Intercare and his doctors that he was working while collecting TTD benefits. Workers' Compensation benefits such as TTD benefits are paid to injured workers who cannot work.
On March 26, 2012, a felony arrest warrant was issued by the Los Angeles Superior Court for Santiago and he was subsequently arrested at his residence and booked at the Los Angeles County Jail. Santiago's bail was set at $120,000. This case was investigated by the Fraud Division's Valencia Regional office.
The Los Angeles County District Attorney's Office is prosecuting this case.
The California Department of Insurance, established in 1868, is the largest consumer protection agency in California, regulating the $123 billion insurance marketplace. In 2013 the California Department of Insurance received more than 170,000 calls from consumers and helped recover over $63 million in claims and premiums. Please visit the Department of Insurance web site at www.insurance.ca.gov. Non-media inquiries should be directed to the Consumer Hotline at 800.927.HELP or 213.897.8921. Telecommunications Devices for the Deaf (TDD), please dial 800.482.4833.