Filed Under:Claims, Investigative & Forensics

Featured Fraud: SoCal Security Breach

One man’s days in the sun could be numbered after he allegedly committed insurance fraud to collect more than $40,000 in undeserved workers’ compensation benefits. 

On March 26, 2012, authorities arrested Julio Santiago, 53, of Rowland Heights, Calif., charging him with grand theft and multiple felony counts, including making false statements and “presenting false or fraudulent written material to obtain compensation.”

According to investigators, on April 9, 2009, Santiago allegedly suffered an industrial injury while working as a security guard for the Hacienda La Puente Unified School District for which he later filed a workers’ compensation claim to Intercare Insurance Services. Apparently Intercare had its own suspicions and conducted a subsequent investigation. As a result of the probe, on May 21, 2009 the company discovered that Santiago was double-dipping: working as a security guard for yet another employer while collecting workers’ compensation benefits.

Failure to Disclose Income

Intercare referred the scam to the California Department of Insurance (CDI) Fraud Division for further investigation. CDI Fraud Division investigators confirmed that Santiago was indeed employed as a security guard for another company during the period of June 2009 to May 2012.

According to a press release issued by California Insurance Commissioner Dave Jones, Santiago collected $29,750 in workers’ compensation benefits for the claimed work-related injury while earning a paycheck for keeping watch at the other company. The scheme didn’t end there, either. Investigators also learned that during the period of June 13, 2009 and February 17, 2010, Santiago received Temporary Total Disability (TTD) benefits in the amount of $13,606.86 from Intercare because his work-related injury supposedly precluded his employment as a security guard.

Following his arrest, Santiago was booked at the Los Angeles County Jail, where he remains under the careful watch of real guards while awaiting trial. Bail has been set at $120,000.

 

 

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