Undercover operation leads to conviction of Maxwell rice mill worker in insurance fraud scheme
News: 2021 Press Release
SACRAMENTO, Calif. — Brooke Gomez, 29, of Maxwell, was convicted and sentenced on one misdemeanor count of workers’ compensation insurance fraud after she claimed to be too injured to work in order to collect workers’ compensation benefits while working for another employer.
Gomez pleaded no contest to the misdemeanor charge and was sentenced in Colusa County Superior Court on April 26, 2021. She was placed on 12 months summary probation and ordered to pay $6,000 in restitution and $630 in fines.
On August 14, 2019, while working as a rice grader, Gomez sustained an abdominal injury while lifting bags of rice. Following her injury, a workers’ compensation claim was filed with her employer’s insurance company and Gomez began receiving workers’ compensation payments.
Gomez told her employer she had been offered several part-time jobs, but declined the offers due to her work injury. However, other mill workers reported to their employer that they witnessed Gomez working as a bartender at a local bar.
An investigation by the California Department of Insurance found Gomez misrepresented her symptoms to medical professionals and those handling her claim. Undercover surveillance showed Gomez interacting with customers, serving drinks, completing cash transactions with patrons and wiping down tables – all functions she claimed not to be able to do as a result of her injury. The surveillance also discovered Gomez discussing her workers’ compensation claim with bar patrons and discussing her hopes of not getting caught working at the bar while receiving workers’ compensation benefits.
Due to Gomez’s misrepresentations, she received $6,893 in undeserved workers’ compensation payments and her employers’ insurance company lost an additional $8,992 in legal and investigation costs.
This case was prosecuted by the Yolo County District Attorney’s Office on behalf of the Colusa County District Attorney’s Office.
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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.