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Surveillance footage leads to charges against Madera woman for workers’ compensation fraud

News: 2021 Press Release

For Release: March 12, 2021
Media Calls Only: 916-492-3566
Email Inquiries: cdipress@insurance.ca.gov
Surveillance footage leads to charges against Madera woman for workers’ compensation fraud

FRESNO, Calif. —  Veronica Catalina Cortes-Ambrosio, 53, of Madera, was charged on two felony counts of insurance fraud after allegedly lying about physical limitations from an injury at work in an attempt to receive undeserved workers’ compensation benefits.

An investigation by the Department of Insurance revealed on May 6, 2017, Cortes-Ambrosio was working for a farm labor company when she was struck with a gardening tool by a co-worker resulting in injuries to her right shoulder, neck, and back. She was evaluated and received initial treatment for the alleged injuries, but the workers’ compensation claim she filed was denied.

Cortes-Ambrosio continued to seek medical care and obtained legal counsel to pursue the claim. She claimed to experience severe and nearly constant pain related to the injury and was unable to perform everyday activities such as sitting, standing, walking, reaching, and lifting. Cortes-Ambrosio’s employer offered her modified duties due to her stated limitations, but she refused and did not return to work.

Video surveillance was obtained of Cortes-Ambrosio during the time she claimed physical limitations due to the injury. The video showed her cleaning in and around her home, doing yardwork, ascending and descending stairs, reaching overhead, and lifting – all tasks she claimed she could not perform and prevented her from returning to work.

Cortes-Ambrosio’s fraudulent claims of ongoing pain and an inability to perform basic work functions, led to her employer’s insurance company paying approximately $48,140 in unnecessary medical, investigative, and legal costs.

Cortes-Ambrosio is scheduled to be arraigned on May 26, 2021. This case is being prosecuted by the Fresno County District Attorney’s Office.     

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The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $340 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $469 million in claims and premiums. Please visit the Department of Insurance website at www.insurance.ca.gov. Non-media inquiries should be directed to the Consumer Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.

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