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Comp Surgery Center in Cahoots with 3 Insurance Company Employees to Fraudulently Negotiate Liens Get 12 Years in Prison

02 Nov, 2010 WorkersCompensation.com

                               
The ring leader in workers compensation insurance fraud scheme that defrauded two insurance companies out of more than $1.4 million was sentenced to 12 years in state prison, the California Franchise Tax Board (FTB) announced (WCxKit).
Rene Montes, 42, of Riverside,  pleaded guilty June 7, 2010, to 122 felony counts including 59 counts of grand theft, 59 counts of insurance fraud, three counts of state income tax evasion, and one felony count of conspiracy, with sentencing enhancements allegations for aggravated white collar crime for loss over $1.5 million and $500,000.
In addition to 12 years in state prison, Montes was ordered to pay more than $1.7 million in restitution with more than $286,000 ordered for FTB for failing to file and report almost $1.5 million in income relating to the insurance fraud during the years 2004, 2005 and 2006. 
Montes, doing business as W.C. Surgery Center, falsely represented to insurance companies he had authority to negotiate liens with them on behalf of medical providers. Information relating to the claims was obtained by Rene Montes through three contacts who worked at the insurance companies. The three co-defendants, Hector Porrata, 46, Moreno Valley, George Martinez, 44, Apple Valley, and Cara Cruz-Thompson, 47, Victorville, pleaded guilty May 7, 2010.
Porrata pleaded guilty to 50 felony counts of grand theft, 50 felony counts of insurance fraud, and 1 felony count of conspiracy. He was sentenced to eight years in state prison and ordered to pay more than $1 million in restitution.
Martinez pleaded guilty to 11 felony counts of grand theft, 11 felony counts of insurance fraud, and one felony count of conspiracy. He was sentenced to two years in state prison and ordered to pay more than $300,000 in restitution. (WCxKit)

Cruz-Thompson pleaded guilty to 12 felony counts of grand theft, 12 felony counts of insurance fraud, and one felony count of conspiracy. She was sentenced to two years in state prison and ordered to pay more than $200,000 in restitution

Author Rebecca Shafer, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing/publishing, pharmaceuticals, retail, hospitality and manufacturing. Contact:  RShafer@ReduceYourWorkersComp.com

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
 
©2010 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@WorkersCompKit.com.

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