News - Tharpe & Howell - Litigation and Transaction Lawyers

THREE PROFESSIONALS BUSTED IN CALIFORNIA

Three California professionals have been charged with insurance fraud. An article recently published by insurancejournal.com is quoated as stating:

"California Insurance Commissioner Steve Poizner announced Thursday the arraignment of two individuals on fraud charges and the sentencing of a third. 'I refuse to tolerate insurance scams in California,' said Commissioner Poizner. 'My teams of investigators will continue their hard work to catch fraud perpetrators and help bring them to justice.'

In the first case, a Department of Insurance (CDI) investigation revealed that Dr. Alice Berkowitz of Los Angeles filed claims with UnumProvident and Liberty Mutual for long-term disability after allegedly suffering an injury in 2004. Berkowitz claimed that her injuries made her unable to work as a clinical psychologist for the remainder of 2004. During the period of Berkowitz's alleged injury, she collected more than $117,000 in benefits from the two carriers. CDI investigators discovered that Dr. Berkowitz continued treating patients during the time she claimed to be injured and collected payments totaling more than $140,000 from as many as 40 patients.

Berkowitz surrendered to CDI fraud investigators Dec. 11 and was booked on multiple counts of insurance fraud and grand theft. On Jan. 3, she was arraigned in Los Angeles County Superior Court. If convicted, Berkowitz could face up to five years in state prison, a fine of up to $50,000, and court-ordered restitution to the insurers she allegedly defrauded.

The second fraud case involved Dr. Jon Fields, 53, of West Hills, who filed a long-term disability claim with his insurance carrier, UnumProvident Corp., for an alleged injury he suffered in 2001. According to insurance company records, Fields claimed that his injury prohibited him from continuing his work as a chiropractor from September 2001 until May 2005. During this period, UnumProvident paid Fields more than $298,000 in benefits. The CDI investigation, however, revealed that Fields allegedly continued treating patients while collecting benefits.

After surrendering to CDI investigators on Dec. 12, Fields was booked on multiple counts of insurance fraud and one count of grand theft. He was arraigned on Jan. 7. If convicted, Fields could be sentenced to up to five years in state prison, a fine of up to $50,000, and court-ordered restitution to UnumProvident.

Lastly, Commissioner Poizner announced the sentencing of a former insurance agent who defrauded an elderly couple of nearly $300,000. Gary Michael Jenkins, 59, of El Cajon, was sentenced Jan. 16 on felony charges and was sentenced to serve a two-year prison term and pay $291,576 in restitution to the victims' estate, in addition to $5,000 in fines.

In an investigation in which the CDI assisted the El Cajon Police Department and the San Diego County District Attorney's Office, it was determined that between June 1, 1994 and Aug. 31, 2002, Jenkins became the trustee of his elderly client's estate. As an agent selling life insurance products, Jenkins manipulated a bond he formed with his clients to steal nearly $300,000 without the victims' knowledge or consent. Additionally, Jenkins created false documents to imply that the money he withdrew from the trust was invested legitimately.

A family member of the victims discovered the theft in 2004 and reported the crime to the El Cajon Police Department. The San Diego County District Attorney's Office prosecuted this case. A restitution hearing will be held Feb. 22 in San Diego County."

Related Practice Area(s):
Bad Faith and Coverage