Two suspects arraigned for 36 felony counts in health care fraud case spanning two states after Department of Insurance investigation
News: 2021 Press Release
BONITA, Calif. — Jacob Hasum Smith, 39, of Bonita, and Charity Lynn Moulder, 61, of Rural Retreat, Virginia, have been charged with 36 felony counts of insurance fraud and grand theft for collecting long-term health care benefits allegedly as a result of fraudulent claims.
After receiving injuries as a result of an automobile collision, Moulder filed a claim with her insurance company under a long-term health care policy, requesting a paid caregiver to assist her during recovery. Moulder originally requested a family member be paid as her caregiver, which was denied. Moulder named another caregiver, Jacob Smith, her daughter’s then boyfriend, and the claim was approved.
Moulder and Smith submitted 38 separate documents reflecting Smith’s reported care of Moulder over a 16-month period of time. The pair claimed Smith cared for Moulder every day, seven days a week, sometimes up to 14 hours a day without a break in service and assisted with bathing, washing, physical assistance, feeding and cleanup along with other tasks. A Department of Insurance investigation revealed that during this same time period, Smith worked and traveled throughout San Diego County and elsewhere in California and Nevada while he reported being with Moulder and providing for her needs, making it impossible for Smith to have cared for Moulder as the claims stated.
Moulder later admitted to detectives that Smith only cared for her part of the time she was collecting benefits but she continued to pay him. She also paid another relative who provided care despite being told by her insurance company that was against policy.
Moulder and Smith were arraigned Tuesday, August 3, 2021. Smith has an outstanding warrant for unrelated charges and is a fugitive at this time.
The San Diego County District Attorney’s Office is prosecuting this case.
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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.