Five Northern Californians Arrested on Charges of Insurance Fraud

On Jan. 13, 2005, Victor Morales Delgado and his brother-in-law, Jose Guerrero, both of Sacramento, self-surrendered to investigators with the California Department of Insurance Organized Auto Insurance Task Force (Task Force) for falsely reporting their vehicle stolen and filing a fraudulent insurance claim.

The suspects were booked into the Sacramento county jail. The Sacramento District Attorney’s Office is prosecuting the case. If convicted on both counts, each suspect could face up to five years in state prison and/or a maximum fine of $150,000.

The California Highway Patrol’s (CHP’s) Mexico Liaison Unit contacted Task Force investigators on April 16, 2004, advising that Mexican authorities had located and impounded Delgado’s 2002 Lincoln Continental on March 18, 2004, after receiving an anonymous call of a vehicle fire. Although the vehicle had not been reported stolen at the time, Mexican and CHP authorities believed the situation was suspicious.

Task Force investigators alleged that Delgado and Guerrero reported Delgado’s vehicle was stolen from the Florin Mall parking lot in Sacramento on March 19, 2004. The next day Delgado allegedly filed an insurance claim with Progressive Insurance for the theft of his vehicle, including the loss of a $4,000 lap top computer as part of the claim. Delgado claimed a total loss of more than $20,000.

The investigation revealed that Delgado could no longer afford the monthly car payments, and so Guerrero took the vehicle to Mexico and flew back to Sacramento, where he accompanied Delgado to Florin Mall to help report the vehicle stolen to mall security and CHP.

Additional, unrelated arrests for insurance fraud have also been made recently throughout the Central Valley and Sacramento area.

On Dec. 8, 2004, Sammy Barela Rios, of Madera, was arrested by investigators from the California Department of Insurance, Fraud Division (CDI) and booked into the Madera county jail on four felony counts of workers’ compensation insurance fraud and one felony count of perjury. If convicted on all counts, Rios could face up to seven years in state prison.

The Madera County District Attorney’s Insurance Fraud Unit is prosecuting the case. Rios is alleged to have presented a false claim for payment of a loss or an injury, stemming from his workers’ comp claim filed while working for the Madera School District.

Rios reportedly injured his left ankle while on the job for Madera School District on Feb. 12, 2003. CDI’s investigation uncovered witness statements that disputed his account of the injury, alleging that Rios was actually injured while working for another employer and that he provided false statements regarding how he had hurt his ankle.

It is also alleged that Rios fraudulently received approximately $2,215 in medical benefits from Claims Management Inc., the school district’s workers’ comp claims manager.

In a separate case, Stacey Wesley Prosser of Manteca was arrested on Nov. 18, 2004, and booked into the San Joaquin county jail on nine felony counts of insurance fraud. If convicted on all counts, Prosser could face up to five years in state prison and/or a maximum fine of $150,000.

This case, also the result of a CDI investigation, is being prosecuted by the San Joaquin County District Attorney’s Office.

Prosser allegedly injured his back on Aug. 22, 2003, while sorting packages for United Parcel Service. He later told doctors and Liberty Mutual Insurance Company that he could barely walk during the first month after the injury, and claimed the most active thing he could do was get the newspaper from the front of his home. During the second month after the injury, Prosser claimed he could do nothing more physical than cook and clean. His treating doctor accordingly placed him on temporary total disability while he recuperated.

CDI’s investigation revealed, however, that shortly after the injury, Prosser was caught on surveillance video racing competitively in a two-day motocross event. When Prosser’s treating physician was shown the surveillance video, the doctor changed his opinion, stating that had the claimant been truthful about his capabilities and symptoms he would not have been put off work.

As a result of these alleged misrepresentations, Liberty Mutual paid out more than $15,000 in disability benefits to Prosser.

Also on Nov. 18, 2004, Cameron Antonio Wilkins, of Colfax, self-surrendered to CDI investigators in yet another unrelated case. Wilkins was booked into the Sacramento county jail on one felony count of insurance fraud associated with the reported theft of his vehicle. Wilkins was employed as a customer service representative in Progressive Insurance’s Rancho Cordova facility.

The Sacramento County District Attorney’s Office is prosecuting the case. If convicted, Wilkins could face up to five years in prison and/or a maximum fine of $50,000.

On Aug. 3, 2004, Wilkins reported to CHP that his 2001 Mitsubishi Eclipse had been stolen from his employer’s parking lot. Later that day Wilkins provided his auto insurance carrier, Mercury Insurance, with a recorded statement regarding the theft of his vehicle.

The next day, however, CHP recovered Wilkins’ vehicle in Colfax and the recovering officer discovered that it had been pushed or rolled down a hill with its transmission placed in park and no signs of either forced or keyed entry. CHP subsequently contacted CDI regarding possible insurance fraud stemming from the alleged theft.

A two-month investigation by CDI alleged that Wilkins gave the vehicle’s keys to his two juvenile brothers on the night of Aug. 2, 2004, who were instructed to “get rid of” the vehicle because it had mechanical problems. Wilkins claimed he could not afford to repair it.

Later, Wilkins admitted he had his brothers dispose of his vehicle because he owed more than it was worth.