Lamont nursery worker arraigned for alleged insurance fraud
News: 2020 Press Release
BAKERSFIELD, Calif. — Fernando Torres Garcia, 46, self-surrendered and was arraigned at the Kern County Superior Court on nearly a dozen felony counts of insurance fraud after allegedly misrepresenting an injury in order to receive undeserved workers’ compensation insurance benefits.
On July 16, 2018, Garcia reported to his employer that he injured his lower back and hip after he slipped while working in a trench to repair a water line. Garcia was diagnosed with a lumbar strain and was placed on modified duty, to which his employer accommodated. Garcia continued to see his doctor as he claimed he was not improving and continued to suffer from pain. Garcia then amended his original workers’ compensation claim to include his entire back, right hip, right thigh, right leg, right elbow, both knees and cumulative trauma.
An investigation by the California Department of Insurance revealed Garcia had numerous doctor visits between August 2018 and March 2019. During this time, surveillance was conducted on Garcia, and revealed he was able to lift heavy objects multiple times. However, since Garcia continuously claimed he was not improving he was referred for an orthopedic evaluation and given a rating of five percent impairment for his lumbar spine.
On June 21, 2019, Garcia underwent a Panel Qualified Medical Evaluation. After the evaluator reviewed Garcia’s medical reports, the surveillance footage, and Garcia’s physical examination and abilities, he determined Garcia did not meet the requirements for any permanent disability or ratable impairment. It was his opinion that Garcia misrepresented his complaints during his examination.
Garcia’s material misrepresentations caused deposition and surveillance expenses totaling $5,873.50.
The Kern County District Attorney’s Office is prosecuting this case. Garcia is scheduled to return to court on November 20, 2020.
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Led by Insurance Commissioner Ricardo Lara, the California Department of Insurance is the consumer protection agency for the nation's largest insurance marketplace and safeguards all of the state’s consumers by fairly regulating the insurance industry. Under the Commissioner’s direction, the Department uses its authority to protect Californians from insurance rates that are excessive, inadequate, or unfairly discriminatory, oversee insurer solvency to pay claims, set standards for agents and broker licensing, perform market conduct reviews of insurance companies, resolve consumer complaints, and investigate and prosecute insurance fraud. Consumers are urged to call 1-800-927-4357 with any questions or contact us at www.insurance.ca.gov via webform or online chat. Non-media inquiries should be directed to the Consumer Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.
