New York Inspector Uncovers $2.7M Workers’ Comp Fraud in 2024
April 17, 2025 | JacobiJournal.com – New York workers’ comp fraud surged in 2024, with Inspector General Lucy Lang reporting $2.7 million in fraudulent activity, marking a nearly 30% increase over 2023. Lang also confirmed 14 arrests, another sharp rise from the prior year. The Inspector General’s findings underscore how New York workers’ comp fraud continues to evolve, creating costly risks for insurers, employers, and state agencies. Significant Recoveries for the State In total, Lang’s office helped recover more than $1.4 million in restitution and fines, returning critical funds to state agencies, insurers, and employers. She shared the figures during an April meeting of the Workers’ Compensation Board. Major Cases from the Inspector General’s Report Lang’s annual report highlighted several high-impact investigations, including: A Call for Continued Oversight Lang emphasized the importance of vigilance in identifying fraud within both public and private sectors. Her office continues to oversee workers’ compensation cases across multiple state agencies, reinforcing efforts to protect taxpayer funds and ensure benefits go only to those who qualify. Source: New York State Inspector General – 2024 Annual Report AQs: About New York Workers’ Comp Fraud What is the scale of New York workers’ comp fraud in 2024? Inspector General Lucy Lang reported $2.7 million in New York workers’ comp fraud cases in 2024, nearly 30% higher than the prior year. Which industries were most impacted by New York workers’ comp fraud? Fraud ranged across sectors, including medical billing, construction, logistics, and public service, highlighting vulnerabilities in both private and public systems. How does the state respond to New York workers’ comp fraud cases? The Inspector General’s office investigates and prosecutes fraud, often recovering restitution. In 2024, more than $1.4 million was returned to agencies and insurers. Stay informed on major fraud cases and enforcement actions—subscribe to JacobiJournal.com for expert analysis, timely updates, and in-depth coverage of workers’ comp fraud. Read More from JacobiJournal.com
LA Couple Sentenced for Underreporting Payroll, Filing False Workers’ Comp Claims
April 15, 2025 | JacobiJournal.com – LA Couple Sentenced: John Nemandoust, 70, and Annette Assil, 62, were sentenced after an investigation uncovered their scheme to underreport over $21 million in payroll and submit false workers’ compensation claims. Nemandoust will serve 60 days in county jail, while Assil will serve 30 days. Both face 10 years of felony probation and must pay $2.2 million in restitution for unpaid workers’ compensation premiums. The LA couple sentenced in this case drew significant attention from state regulators because of the scale of the fraud and the direct impact on California’s workers’ compensation system. Authorities emphasized that the outcome reinforces how aggressively prosecutors are pursuing employers who attempt to evade insurance requirements through underreporting or false claims. Investigation Reveals Extensive Underreporting The California Department of Insurance (CDI) initiated the investigation into the couple’s three businesses: A-1 Valley Services, Prompt Delivery, and Affordable Messenger. From 2013 to 2017, the couple failed to secure workers’ compensation coverage for two of the companies. Only A-1 Valley Services had insurance, leaving Prompt Delivery and Affordable Messenger uninsured. The couple sentenced for these violations not only underreported payroll but also left employees vulnerable by operating without proper coverage. Investigators noted that uninsured operations put both workers and legitimate businesses at risk, since fraud of this scale shifts costs onto honest employers and weakens the integrity of the workers’ compensation system. Filing False Claims to Evade Payments When employees from the uninsured companies were injured, the couple allegedly filed false claims under the A-1 Valley Services policy. Investigators discovered that the couple misreported $25 million in payroll, only reporting $1.4 million to their insurance carrier. This allowed them to avoid paying $3 million in premiums. The couple sentenced in this case used fraudulent claims not just to sidestep premium payments, but also to conceal the true scale of their business operations. Prosecutors stressed that these actions undermined the workers’ compensation system, creating unfair advantages over law-abiding employers and placing legitimate insurance carriers at financial risk. Court’s Ruling and Sentence The Los Angeles County District Attorney’s Office prosecuted the case. Nemandoust and Assil will serve their sentences and face continued supervision under probation. Source: California Department of Insurance – CDI Press Release FAQs: LA Couple Sentenced Workers Comp Fraud What were the charges in the LA couple sentenced workers comp fraud case? They were convicted of underreporting $21 million in payroll and filing false workers’ comp claims to avoid $3 million in premiums. How much restitution was ordered in the LA couple sentenced workers comp fraud case? The court ordered $2.2 million in restitution for unpaid workers’ compensation premiums as part of the sentencing. Why is the LA couple sentenced workers comp fraud case significant? It highlights how California authorities, including CDI and local prosecutors, pursue large-scale fraud schemes to protect workers and ensure fair premium payments. What penalties did the face beyond restitution? In addition to paying $2.2 million in restitution, the couple sentenced received county jail time and 10 years of felony probation, ensuring long-term oversight of their activities. How does the case impact other California employers? The couple sentenced case serves as a warning to other business owners that underreporting payroll or filing false claims can lead to severe legal consequences, including jail, probation, and financial penalties. Stay updated on major workers’ comp fraud cases—subscribe to JacobiJournal.com for breaking news, expert analysis, and enforcement updates. Read More from JacobiJournal.com
American Labor Alliance Execs Convicted in Multi-Million Dollar Fraud
April 15, 2025 | JacobiJournal.com — American Labor Alliance Execs Convicted: After a 19-day trial, a federal jury convicted three Fresno defendants of orchestrating a sweeping fraud involving fake pension plans, bogus workers’ compensation coverage, and sham hardship exemptions. U.S. Attorney Phillip A. Talbert announced the verdict Tuesday. Marcus Asay, 68, Antonio Gastelum, 53, and their business—Agricultural Contracting Services Association, doing business as American Labor Alliance (ALA)—ran the schemes from 2011 through 2019, targeting thousands of workers and businesses across the country. Fraudulent Retirement Plan Misled Over 3,000 Workers Asay, founder and chairman of ALA, and Gastelum, who held multiple executive titles, convinced over 3,000 individuals to invest in a fake 401(k) retirement plan. Instead of managing the funds properly, the defendants funneled contributions into personal and business expenses. This included luxury dining, rare coins, online companion services, and rent for Asay’s lakefront home in Fresno. American Labor Alliance Execs To conceal the misappropriation, the defendants used funds from another fraudulent operation—fake workers’ compensation coverage—to cover supposed pension obligations. Losses from the retirement scheme exceeded $750,000. Workers’ Compensation Scam Involved Fake Insurance Certificates The second scheme involved false promises of workers’ compensation coverage. ALA told customers in California and other states that major national insurers backed their policies. In reality, those insurers were never involved. To maintain the illusion, ALA issued counterfeit certificates and policy declarations, allowing businesses to submit fraudulent documents to clients and regulators. When investigations began, ALA urged customers not to cooperate with authorities. The total fraud in this area exceeded $2.25 million. Hardship Exemptions Sold Under False Pretenses Asay and ALA also ran a third grift by charging individuals for bogus exemptions from the Affordable Care Act’s insurance mandate. While they promised to shield buyers from the ACA’s shared responsibility payment, the exemptions were neither valid nor legal. Only government agencies can issue such exemptions—and they’re free for qualified individuals. Sentencing and Potential Penalties The three defendants face sentencing on October 21, 2024, before U.S. District Judge Dale A. Drozd. Each fraud conviction carries up to 20 years in prison, with fines ranging from $250,000 to $500,000 per count. ALA could be fined up to $8.5 million. The case was investigated by multiple federal agencies, including the FBI, IRS Criminal Investigation, and Department of Labor, with prosecution led by Assistant U.S. Attorneys Michael Tierney, Joseph Barton, and Stephanie Stokman. Source: U.S. Department of Justice – DOJ Press Release FAQs: American Labor Alliance Execs Convicted Fraud Case What schemes were the American Labor Alliance execs convicted of? The American Labor Alliance execs convicted were found guilty of running fraudulent pension plans, fake workers’ compensation coverage, and bogus ACA exemptions. How many victims were impacted by the American Labor Alliance execs convicted case? Over 3,000 workers and numerous businesses nationwide were affected by the schemes tied to the American Labor Alliance execs convicted verdict. What penalties do the American Labor Alliance execs convicted face? The American Labor Alliance execs convicted face up to 20 years in prison per fraud count, millions in fines, and restitution for defrauded victims. Stay informed about major fraud cases and workers’ compensation enforcement at JacobiJournal.com. Read More from JacobiJournal.com
Former Girardi Keese Accountant Sentenced for Fraud
Former Girardi Keese Accountant: Kamon ordered to pay nearly $9M in restitution for role in law firm’s collapse April 15, 2025 | JacobiJournal.com — A former top accountant at the now-defunct Girardi Keese law firm has been sentenced to over 10 years in prison for defrauding both the firm and its clients. The ruling delivers a sharp blow to those involved in one of California’s most notorious legal scandals. Court Sentences Kamon to Over 10 Years Christopher Kazuo Kamon, 51, received a 121-month federal prison sentence from Judge Josephine L. Staton. The court also ordered him to pay nearly $9 million in restitution. Authorities arrested Kamon in The Bahamas in late 2022. He later pleaded guilty to two counts of wire fraud in October 2024. Judge Staton called Kamon a central player in a “web of deceit and manipulation.” She emphasized that his actions deepened the harm inflicted on vulnerable clients. Millions Stolen from Settlement Funds Kamon worked alongside Tom Girardi, 85, to steal from injured clients over a decade. One of the worst cases involved a burn victim from the 2010 San Bruno gas pipeline explosion. Girardi had secured a $53 million settlement. However, he told the client it was only $7 million. Rather than protect the client’s funds, Kamon helped reroute the money to cover law firm expenses. He and Girardi also used it to pay previous victims whose own settlements had already been misappropriated. To keep the deception going, they sent small “interest” checks and false updates about nonexistent accounts. Kamon Profited from the Scheme Kamon didn’t just help embezzle funds—he also used the firm’s money to enrich himself. He set up fake vendors and submitted fraudulent invoices to pay for renovations at his homes in Encino and Palos Verdes. In one outrageous move, he funneled hundreds of thousands of dollars to a female companion, including a $20,000 monthly stipend. She had no ties to the law firm. These payments came directly from the firm’s operating accounts. Kamon’s Actions Accelerated the Firm’s Collapse Federal officials said Kamon’s misconduct helped accelerate the law firm’s downfall. Girardi Keese filed for bankruptcy in December 2020 and dissolved by early 2021. The State Bar of California disbarred Girardi in July 2022. A jury recently found him guilty of multiple counts of wire fraud. Meanwhile, Kamon, Girardi, and former Girardi Keese lawyer David R. Lira now face a second criminal trial in Chicago this July. Federal Authorities Vow Continued Accountability U.S. Attorney Bill Essayli stated, “Kamon enabled Girardi’s scheme for nearly 20 years. Ironically, his own lies helped bring it to an end.” IRS Special Agent Tyler Hatcher added, “Kamon treated the firm’s finances like a personal piggy bank. Our teams traced every dollar and helped bring him to justice.” The IRS Criminal Investigation Division and the FBI led the investigation. Prosecutors continue to recover assets for victims of the scheme. Source: U.S. Department of Justice FAQs: Former Girardi Keese Accountant Sentenced What was the sentence in the Former Girardi Keese accountant sentenced case? Christopher Kazuo Kamon received over 10 years in federal prison and was ordered to pay nearly $9 million in restitution. How did the Former Girardi Keese accountant sentenced case impact clients? Kamon helped divert millions from client settlement funds, including money from a $53 million gas explosion settlement, worsening harm to victims. What role did Kamon play in the Former Girardi Keese accountant sentenced case? Kamon was a central figure who created fake vendors, misused firm accounts, and funneled money to personal luxuries and companions. Stay informed on high-profile legal fraud cases like the Former Girardi Keese accountant sentenced ruling. Subscribe to JacobiJournal.com today for trusted updates and expert analysis. Read More from JacobiJournal.com
Jury Awards $145M for Unreasonable Denial of Comp Claim
April 14, 2025 | JacobiJournal.com – Jury Awards $145M: Insurance company held accountable for denying worker’s legitimate claim: A California jury has awarded $145 million to a worker after determining that his workers’ compensation claim was wrongfully denied by his employer’s insurance company. The ruling highlights the financial consequences that insurers face when denying legitimate claims in bad faith. Case Background The worker, employed in construction, suffered serious injuries after falling at his worksite. His workers’ compensation claim was submitted in accordance with California law but was rejected by the insurance company, which cited insufficient evidence of injury severity. As a result, the worker had to pay for his medical treatments out of pocket, leading to financial and emotional distress. Legal Ruling and Jury’s Decision After a lengthy trial, the jury ruled that the insurance company acted in bad faith by unreasonably denying the claim. The jury found that the insurer’s actions caused undue hardship for the worker, who had no alternative for covering medical expenses and lost wages. Jury Awards $145M “This ruling sends a strong message to insurers that they cannot deny legitimate claims without facing serious consequences,” said the worker’s attorney. “This award speaks to the harm caused by bad faith actions in workers’ compensation claims.” Broader Implications for Insurers This landmark case is expected to set a significant precedent for future workers’ compensation lawsuits in California. Legal experts suggest that insurers will now face heightened scrutiny regarding their claim review processes. The verdict underscores the importance of ensuring timely and fair compensation for workers injured on the job. Source: Legal News Network FAQs: Jury Awards $145M Workers Comp Claim What led to the Jury awards $145M workers comp claim verdict? The case stemmed from an insurer’s bad faith denial of a legitimate construction worker’s compensation claim, which left the worker covering his own medical costs. How does the Jury awards $145M workers comp claim ruling impact insurers? It signals heightened scrutiny of insurers’ claims practices, warning that unreasonable denials may result in massive financial penalties. Why is the Jury awards $145M workers comp claim significant for workers? The verdict reinforces workers’ rights to fair compensation, discouraging insurers from delaying or denying legitimate claims without evidence. FAQs: Jury Awards $145M Workers Comp Claim What led to the Jury awards $145M workers comp claim verdict? The case stemmed from an insurer’s bad faith denial of a legitimate construction worker’s compensation claim, which left the worker covering his own medical costs. How does the Jury awards $145M workers comp claim ruling impact insurers? It signals heightened scrutiny of insurers’ claims practices, warning that unreasonable denials may result in massive financial penalties. Why is the Jury awards $145M workers comp claim significant for workers? The verdict reinforces workers’ rights to fair compensation, discouraging insurers from delaying or denying legitimate claims without evidence. Stay informed on landmark rulings like the Jury awards $145M workers comp claim decision. Subscribe to JacobiJournal.com today for expert legal insights and trusted fraud case updates. Read More from JacobiJournal.com
Labor Organization Owners Sentenced in Union Fraud Scheme
April 14, 2025 | JacobiJournal.com – Labor organization owners sentenced in a high-profile union fraud case, shining a spotlight on corruption within labor institutions and the urgent need for accountability. Two Southern California labor organization owners will serve time in federal prison after admitting to a fraud scheme that embezzled more than $500,000 in union funds. Their sentencing underscores a broader crackdown on union-related financial crimes and highlights how misuse of worker contributions erodes trust in organizations designed to protect employees. This case marks another aggressive move by federal authorities to confront white-collar corruption in labor institutions. Officials emphasized that the ruling sends a message to leaders of labor groups nationwide: safeguarding union funds is a fiduciary duty, and those who breach it for personal gain will face serious legal consequences. Fraud Scheme Diverted Union Funds for Luxury and Travel According to the U.S. Department of Justice, the defendants ran a labor nonprofit allegedly dedicated to protecting workers’ rights. However, investigators uncovered that the organization was used as a front to finance personal luxuries. They diverted funds toward extravagant travel and high-end purchases, betraying the trust of union members in the process. Labor Organization Owners Sentenced Falsified Invoices and Shell Companies Used to Conceal Theft To mask the scheme, the pair falsified financial records, created fake invoices, and routed money through shell companies. These tactics were aimed at avoiding detection while continuing to misuse union funds. Prosecutors emphasized the significance of the betrayal, noting that such actions undermine confidence in legitimate labor movements. Federal Sentencing Underscores Severity Following a thorough investigation and prosecution, both individuals received multi-year federal prison terms and were ordered to pay restitution. The court’s decision sends a firm message: those who exploit positions of public trust, especially within labor organizations, will face serious consequences. Heightened Scrutiny for Union Oversight This case is part of a broader federal effort to increase oversight of labor organizations. As government agencies ramp up enforcement, unions are being urged to adopt tighter compliance measures and improve financial transparency. Employers and union representatives should review internal controls regularly to avoid costly liability or legal exposure. For more information on federal enforcement and union oversight, visit the U.S. Department of Justice – Office of Labor-Management Standards (OLMS). FAQs: Labor Organization Owners Sentenced What crimes were the labor organization owners sentenced for? They were sentenced for embezzling over $500,000 in union funds, falsifying invoices, and using shell companies to conceal the theft. How long will the labor organization owners sentenced serve in prison? Both defendants received multi-year federal prison terms along with restitution orders for the stolen union funds. Why is the labor organization owners sentenced case significant? It highlights the federal government’s aggressive stance on union fraud and underscores the importance of financial transparency in labor organizations. Stay informed about union fraud, compliance enforcement, and insurance-related legal actions at JacobiJournal.com. Subscribe for updates that matter to employers, investigators, and compliance professionals. Read More from JacobiJournal.com:
Three Floridians Plead Guilty in Workers’ Comp, Tax Fraud Scheme
April 10, 2025 | JacobiJournal.com — Three Floridians Plead Guilty: Three Orlando residents have pleaded guilty to federal charges in a sweeping fraud scheme that evaded tens of millions of dollars in workers’ compensation insurance premiums and payroll taxes, according to federal prosecutors. The case, now gaining national attention, highlights how construction-related fraud can undermine both state insurance funds and the IRS. Federal officials emphasized that when Three Floridians Plead Guilty to orchestrating such a large-scale scheme, it signals a broader warning to contractors and business owners who might consider similar tactics. Authorities noted that this case is part of a coordinated effort to dismantle “ghost employee” networks and shell company operations that cheat insurers and taxpayers. By entering their guilty pleas, the defendants admitted to conduct spanning nearly a decade and involving millions in fraudulent transactions. Legal analysts point out that the outcome in which Three Floridians Plead Guilty also underscores the government’s aggressive stance on holding individuals accountable for both workers’ compensation and tax fraud. Plea Agreements and Potential Sentences Eduardo Anibal Escobar, Carlos Alberto Rodriguez, and Adelmy Tejada, all legal permanent residents from El Salvador, admitted to conspiring to commit wire fraud and tax fraud. Each defendant now faces up to 20 years in prison for the wire fraud charge and up to 5 years for the tax fraud offense. Three Floridians Plead Guilty As part of the plea deal, the court ordered the trio to forfeit $8.76 million in profits and two Orlando homes purchased with illicit funds. Additionally, they must pay restitution totaling: How the Scheme Operated Beginning in January 2015 and continuing through August 2024, the defendants carried out a complex scheme to defraud the insurance system and the IRS. They registered shell companies with the State of Florida, secured workers’ compensation policies that listed only a few employees and minimal payroll, and then falsely claimed to employ hundreds of subcontractors. To execute the scheme, the trio partnered with construction subcontractors who needed insurance coverage. These subcontractors, often employing undocumented workers, paid the defendants to falsely represent that the workers were on their payroll. In return, the defendants provided documents to general contractors claiming the workers were insured through their companies. As a result, the general contractors issued checks to the defendants’ shell companies. The trio then distributed the funds to the subcontractors’ workers—while keeping 6% to 8% in fees. The Financial Impact Over the course of the scheme, approximately $146 million in payroll flowed through the defendants’ companies. However, they failed to report this payroll to the IRS and avoided paying the associated taxes. Had they reported it properly, they would have owed nearly $37 million in payroll taxes. Furthermore, insurance companies believed they were covering only the limited payroll amounts reported on the applications. In reality, they unknowingly provided coverage for the much larger unreported payroll, missing out on an estimated $13 million in premiums. Ongoing Federal Crackdown This case forms part of a broader federal effort targeting fraud in the construction industry, particularly the use of “ghost” employees and shell companies. The investigation was led by Homeland Security Investigations, IRS-Criminal Investigation, and the Florida Department of Financial Services. Assistant U.S. Attorney Arnold B. Corsmeier is prosecuting the case, while Jennifer M. Harrington is handling asset forfeiture. Although the sentencing dates have not yet been set, authorities emphasized that similar investigations remain ongoing. For official updates on federal labor fraud enforcement, visit the U.S. Department of Justice – Criminal Division. FAQs: Three Floridians Plead Guilty Fraud Case What charges did the three Floridians plead guilty to in the fraud case? The three Floridians pleaded guilty to conspiring to commit wire fraud and tax fraud, charges that carry up to 20 years and 5 years in prison, respectively. What restitution was ordered in the three Floridians plead guilty case? The court ordered $12.99 million to insurers, nearly $37 million in payroll taxes, and $397,895 for fraudulent workers’ comp claims. How did the scheme in the three Floridians plead guilty case operate? The defendants used shell companies and false payroll reports to avoid paying premiums and taxes, while subcontractors paid them for fraudulent coverage. Stay ahead of fraud news and enforcement actions. Subscribe to JacobiJournal.com today for weekly updates on workers’ comp, tax fraud, and public integrity cases. 🔎 Read More from JacobiJournal.com:
LA Delivery Owners Ordered to Pay $2.25M in Restitution
April 9, 2025 | JacobiJournal.com — LA Delivery Owners Ordered: The owners of three Los Angeles-based delivery companies have been ordered to pay more than $2.25 million in restitution after underreporting over $21 million in employee payroll to avoid workers’ compensation insurance premiums. This ruling underscores how seriously California regulators and prosecutors are cracking down on payroll fraud in the delivery and logistics sector. By deliberately misclassifying payroll and concealing true employee numbers, the defendants were able to gain an unfair advantage over compliant businesses while exposing their workers to significant risk. The decision comes amid a broader state and national push to hold business owners accountable for misreporting payroll and avoiding legally mandated insurance obligations. With the restitution amount exceeding $2.25 million, the case highlights the real financial impact of enforcement actions and sends a message to other companies considering similar misconduct. Sentencing Details On April 3, 2025, the California Department of Insurance (CDI) announced that John Nemandoust, 70, and Annette Assil, 62, were sentenced for their roles in the scheme. Nemandoust received 60 days in county jail, while Assil received 30 days. Both were also sentenced to 10 years of felony probation and must repay $2,254,748 in unpaid insurance premiums. LA Delivery Owners Ordered How the Scheme Worked The couple operated A-1 Valley Services, Prompt Delivery, and Affordable Messenger. Between 2013 and 2017, they only purchased workers’ comp coverage for A-1 Valley Services. Meanwhile, the other two companies remained uninsured. When workers from the uninsured companies were injured on the job, the owners allegedly filed the claims under A-1 Valley’s insurance policy. Investigative Findings A forensic audit revealed that the companies had a combined gross payroll of more than $25 million. However, they only reported $1.4 million to their insurance carrier. This misreporting allowed them to evade approximately $3 million in insurance premiums. The Los Angeles County District Attorney’s Office prosecuted the case following a CDI investigation. Source: Los Angeles County District Attorney’s Office For official details, see the California Department of Insurance report: California Department of Insurance – News Releases. FAQs: LA Delivery Owners Why were the LA delivery owners ordered to pay $2.25M in restitution? They underreported more than $21 million in payroll to avoid workers’ compensation insurance premiums, leading to their sentencing and restitution order. What penalties did the LA delivery owners face besides restitution? John Nemandoust received 60 days in jail, Annette Assil received 30 days, and both were sentenced to 10 years of felony probation. How did investigators uncover the fraud involving the LA delivery owners? A forensic audit by the California Department of Insurance revealed the misreported payroll and fraudulent use of one company’s insurance policy for claims. Stay ahead on major insurance fraud prosecutions like this one. Subscribe to JacobiJournal.com for breaking fraud news and legal updates. 🔎 Read More from JacobiJournal.com:
Women Charged With Fraud After SUV Found in Mississippi River
April 8, 2025 | JacobiJournal.com — Women Charged With Fraud: A routine stolen vehicle report took a surprising turn on March 21, when authorities discovered a partly submerged SUV in the Mississippi River—the same one reported stolen just moments earlier. Suspicious Discovery in the Water After receiving the initial 911 call about the stolen Ford Expedition, a second call came in about a vehicle found in the river near a landing. Local responders, including the Warren County Sheriff’s Office, fire-rescue crews, and search teams, rushed to the scene. Using a skiff launched from a nearby boat, authorities conducted a thorough search. However, they found no one inside the SUV or in the surrounding waters, according to the Vicksburg Daily News. Fraud Uncovered Soon after, investigators confirmed that the submerged Ford Expedition belonged to Heather Kay McCoy, the woman who had reported it stolen. On April 1, law enforcement arrested McCoy and charged her with insurance fraud. Authorities also arrested Amber Spencer, whom they identified as an alleged accomplice. She was charged with conspiracy to commit a felony. Next Steps in the Case Although officials did not release details on how they quickly uncovered the fraud attempt, both women posted bail. The case is now pending a grand jury review, expected in the coming weeks. Learn more about how Mississippi investigates and prosecutes insurance fraud. FAQs: Women Charged With Fraud What happened in the case of the women charged with fraud in Mississippi? Authorities discovered a submerged SUV in the Mississippi River, leading to insurance fraud charges against two women. Who were the women charged with fraud, and what are the accusations? Heather Kay McCoy was charged with insurance fraud after reporting her own SUV stolen, while Amber Spencer was charged with conspiracy. What happens next in the women charged with fraud case? Both women posted bail, and the case is scheduled for grand jury review in the coming weeks. Stay updated on major fraud cases and accountability news. Subscribe to JacobiJournal.com for expert coverage of fraud, justice, and public integrity stories. 🔎 Read More from JacobiJournal.com:
San Diego Plumber Fined Over $1M for Workers’ Comp Fraud
April 7, 2025 | JacobiJournal.com — San Diego Plumber Fined: Daniela G. Birdwell, a Spring Valley-based plumbing contractor and owner of GPS Plumbing, has been ordered to pay $1,030,062 in restitution. The penalty follows her guilty plea in a workers’ compensation premium fraud case, according to the San Diego County District Attorney’s Office. The plumber fined in this case admitted to intentionally underreporting payroll in order to avoid paying higher workers’ compensation premiums, a scheme that allowed her business to operate at a lower cost while putting employees and honest competitors at a disadvantage. Prosecutors emphasized that this type of fraud is not a victimless crime. Workers lose the protection they are legally entitled to if injured on the job, while insurers and policyholders shoulder increased costs. Sentencing and Penalties As part of the plea agreement, Birdwell will serve two years of probation. She must also complete 320 hours of community service and pay $10,000 per month toward restitution. District Attorney Summer Stephan commented on the case: “Employers who engage in premium fraud are not only breaking the law, but they also gain an unfair advantage over their competitors. Our Insurance Fraud Division remains committed to holding these businesses accountable, protecting workers, and ensuring a level playing field.” Discovery of the Fraud The fraud was discovered during a routine audit by the State Compensation Insurance Fund. Investigators noticed major differences between payroll figures reported to the Employment Development Department (EDD) and those reported during the company’s insurance audits. San Diego Plumber Fined As a result, the State Fund found millions of dollars in unreported payroll between June 2016 and May 2021. The Investigation and Prosecution Following the audit, the State Fund’s Special Investigation Unit submitted its findings to both the San Diego County District Attorney’s Office and the California Department of Insurance. Consequently, this led to Birdwell’s prosecution and sentencing. The Broader Impact of Insurance Fraud Insurance fraud remains a serious and costly issue. Nationwide, it costs consumers between $80 billion and $90 billion annually. In California, it accounts for nearly $15 billion each year. Notably, it ranks as the second-largest economic crime in the state, just behind tax evasion. For official guidance and updates on workers’ compensation fraud cases, visit the California Department of Insurance – Workers’ Compensation Fraud. FAQs: About San Diego Plumber Fined Case What was the San Diego plumber fined for? The San Diego plumber fined over $1M, Daniela Birdwell, was convicted of workers’ compensation premium fraud after underreporting payroll for years. How much must the San Diego plumber fined in the fraud case pay back? Daniela Birdwell was ordered to pay $1,030,062 in restitution, with $10,000 monthly installments, alongside probation and community service. Why is the San Diego plumber fined case significant for businesses? The San Diego plumber fined case highlights how insurance fraud gives businesses an unfair advantage and puts honest employers and workers at risk. How was the case uncovered? The San Diego plumber fined more than $1 million was investigated after a State Compensation Insurance Fund audit revealed discrepancies between payroll records reported to state agencies and insurance audits. Why is the case significant for California? The San Diego plumber fined case highlights how workers’ comp fraud undermines fair business practices, drives up costs for honest employers, and impacts the integrity of California’s insurance system. Stay informed on the latest fraud cases and accountability news. Subscribe to JacobiJournal.com for weekly updates on workers’ comp fraud, healthcare fraud, and public integrity prosecutions. 🔎 Read More from JacobiJournal.com: