Six Arrested in Suspected Calif. Workers’ Comp Fraud Ring

California Insurance Commissioner John Garamendi has announced the arrest of six suspects following a two-year, multi-agency undercover investigation into an alleged insurance fraud “mill” that reportedly swindled insurance companies with false billings.

The arrests came after a Grand Jury handed down indictments related to the investigation, called “Operation Double Helix.” Chiropractors and employees at several chiropractic clinics and a law firm are suspected of submitting fraudulent insurance bills, offering excessive treatments and recruiting others to pose as patients.

Operation Double Helix began in 2003 as a joint investigation by the California Department of Insurance Fraud Division and the Merced County District Attorney’s Office. The Fresno County District Attorney’s Office assisted in the investigation, which received cooperation from the California State Automobile Association, GEICO, Liberty Mutual Insurance, and Foster Farms.

CDI said the investigation began in response to a large number of complaints from insurance carriers regarding suspicious activity by the suspects. Many of the reported incidents allegedly happened at the chiropractic offices of John Aguilar Jr., 45, a Fresno, Calif.-based chiropractor who owned Twin Valley Clinic and other clinics in Sacramento, Merced and Fresno.

Authorities said that in May of 2003, the involved enforcement agencies began using undercover operatives to pose as victims of automobile accidents. The undercover operatives would go to the clinics owned by Aguilar and report that they had suffered either very minor injuries or no injuries at all.

Despite that, they were still given excessive chiropractic treatment and offered payments to recruit other individuals to make additional fraudulent insurance claims, according to investigators. In addition, the undercover operatives were referred to a law firm owned by Ngoan Van Dao, 69, of Westminster, Calif. Unlicensed employees would allegedly act as attorneys representing the “victims,” helping them gain settlements for their claims.

The law firm’s employees also allegedly offered jobs to undercover operatives that would require them to recruit more people for the scam. Fraudulent and exaggerated billings were made to both workers’ compensation and automobile insurance carriers.

Others arrested in the case include: Juan S. DeLaVara, 35, of Riverbank, a chiropractor formerly employed by Twin Valley Chiropractic in Merced; Ngia (aka: Mike) Thao, 24, of Merced, a former assistant manager at Twin Valley; Scott F. Saephanh, 41, of Merced, office manager of the Law Office of N. Van Dao in Merced; and Toua Thomas Vang, 37, of Merced, assistant office manager at the law firm.

The suspects were charged with a variety of offenses, including insurance fraud, conspiracy to commit insurance fraud, grand theft, conspiracy to practice law without a license, and capping. If convicted the maximum sentences are: two to five years in prison on each count of insurance fraud and conspiracy to commit insurance fraud; 16 months to three years in prison for capping; one year in prison for grand theft; and 16 months to three years for conspiracy to practice law without a license. Each count also carries a maximum fine of $50,000.