Los Angeles Delivery Owners to Repay for Workers’ Comp Fraud
April 7, 2025 | JacobiJournal.com — Los Angeles delivery owners to Repay for workers’ compensation fraud: On April 3, 2025, the California Department of Insurance (CDI) announced the sentencing of John Nemandoust, 70, and Annette Assil, 62, for a long-running workers’ compensation fraud scheme. The Los Angeles couple underreported more than $21 million in employee payroll across their three delivery companies. Sentencing and Restitution A judge sentenced Nemandoust to 60 days in county jail and Assil to 30 days. In addition, both received 10 years of felony probation and must repay $2,254,748 in restitution for unpaid workers’ compensation insurance premiums. The restitution order is intended not only to recover the financial losses caused by their scheme but also to reinforce the seriousness of workers’ compensation fraud in California. The probation terms mean the couple will remain under close supervision for a decade, with any violations potentially resulting in harsher penalties. Restitution payments are also structured to ensure accountability over the long term, signaling that financial misconduct in the insurance system carries lasting consequences for those involved. Uninsured Companies and Fake Claims CDI began investigating after learning that two of the couple’s businesses—Prompt Delivery and Affordable Messenger—operated without workers’ compensation insurance. The third company, A-1 Valley Services, held an active policy. Between 2013 and 2017, the couple only insured Valley Services. When employees from the uninsured companies suffered work-related injuries, Nemandoust and Assil submitted their claims under Valley Services’ policy. Investigators confirmed that at least 20 claims were improperly filed during this time. Los Angeles Delivery Owners Massive Payroll Underreporting A forensic audit revealed that the companies had a combined gross payroll of over $25 million, but only reported about $1.4 million to their insurer. As a result, they dodged nearly $3 million in workers’ comp premiums. The scale of the underreporting highlighted how even large operations can conceal payroll numbers to manipulate premium costs. Auditors determined that the gap between the actual payroll and reported figures was so significant that it could not have been the result of simple clerical errors. Instead, the evidence pointed to a deliberate effort to avoid paying into the workers’ compensation system. This manipulation not only harmed the insurance carrier but also placed honest businesses at a disadvantage by distorting the true cost of coverage in the industry. Prosecution The Los Angeles County District Attorney’s Office prosecuted the case, emphasizing the importance of holding business owners accountable for defrauding state insurance systems. For readers seeking more information on how California combats workers’ compensation fraud, visit the California Statewide Law Enforcement Association. FAQs: Los Angeles Delivery Owners Fraud Case Why were the Los Angeles Delivery Owners sentenced? The Los Angeles delivery owners were sentenced for underreporting more than $21 million in payroll across their three companies to avoid paying workers’ compensation insurance premiums. How much must the delivery owners repay? The court ordered the Los Angeles delivery owners to pay $2,254,748 in restitution to cover unpaid workers’ comp insurance premiums. What fraudulent actions did the delivery owners commit? They operated two companies without workers’ comp insurance and filed at least 20 fake claims under their insured company’s policy, while misrepresenting payroll. What does this case mean for other employers? This case highlights that employers who commit payroll or insurance fraud will face prosecution, restitution, and potential jail time under California law. Stay updated on workers’ compensation fraud cases and legal accountability. Subscribe to JacobiJournal.com for the latest news and expert analysis. 🔎 Read More from JacobiJournal.com:
Pennsylvania Woman Charged for Fraudulent Claim on TV
April 4, 2025 | JacobiJournal.com — Pennsylvania Woman Charged: A woman from Pennsylvania now faces insurance fraud charges after claiming wind damage to her barn, even though a reality TV crew had already taken it apart. TV Deal Leads to Investigation Tracey Jeffreys, 63, from the Milton area, initially struck a deal with the Discovery Channel’s “Barnwood Builders”. The show planned to dismantle her old barn and use the wood in a reconstruction project. However, after inspecting the structure in 2022, the crew found part of the wood was infested with powder post beetles. As a result, they decided to salvage only some usable sections, and Jeffreys received $20,000 for the materials. $100K Insurance Claim Raises Suspicions Soon after the transaction, Jeffreys submitted a $100,000 claim to Donegal Mutual Insurance, stating that strong winds had knocked down part of the barn. Yet, an insurance adjuster couldn’t verify that wind caused the damage. Weather Records and Witnesses Contradict the Claim Investigators then checked National Oceanic and Atmospheric Administration (NOAA) data. On the day of the supposed damage, wind speeds averaged just 7 mph, far too low to destroy a barn. In addition, neighbors reported seeing the TV crew take the structure apart. The show’s team also confirmed they had dismantled the barn as planned. Pennsylvania Woman Charged Jeffreys Tries to Backtrack When confronted, Jeffreys attempted to withdraw her claim. She claimed she had forgotten to tell the crew not to remove the section she now said was damaged by wind. The Pennsylvania Attorney General’s Office has charged her with insurance fraud, and she was released on bail. For readers who want to learn more about fraud enforcement in Pennsylvania, refer to the Pennsylvania Attorney General’s Insurance Fraud Section: Pennsylvania Attorney General – Insurance Fraud. FAQs: Pennsylvania Woman Charged in Insurance Fraud Why was the Pennsylvania woman charged with insurance fraud? She was charged after investigators discovered her $100K insurance claim conflicted with TV crew records and NOAA weather data. How did the TV show play a role in the case? The Discovery Channel’s Barnwood Builders dismantled her barn before the alleged storm, exposing her fraudulent claim. What evidence proved the Pennsylvania woman charged was lying? NOAA reports showed low wind speeds that day, and witnesses confirmed the TV crew—not a storm—removed the barn. What penalties could the Pennsylvania woman charged face? If convicted, she could face fines, restitution, and possible jail time under Pennsylvania’s insurance fraud laws. Stay informed about major fraud prosecutions and legal updates like this case. Subscribe to JacobiJournal.com for weekly fraud and law enforcement news. 🔎 Read More from JacobiJournal.com:
California Bill: Insurers Notify Owners for Aerial Inspection
April 3, 2025 | JaocbiJournal.com — A new California bill, Assembly Bill 75 (AB 75), would require insurance companies to notify homeowners at least 30 days in advance before conducting aerial imaging inspections. The bill also mandates that insurers provide policyholders with instructions on how to request access to the aerial photos taken of their property. Transparency in Insurance Inspections The bill, authored by Assemblymember Lisa Calderon (D-Whittier), aims to increase transparency in insurance inspections and help homeowners retain affordable coverage. Calderon, who chairs the Assembly Insurance Committee, emphasized the need for this legislation amid rising non-renewals and cancellations. California Bill “We are in the middle of an insurance crisis, and Californians are facing non-renewals or policy cancellations, sometimes without justification. AB 75 empowers homeowners, especially those at risk of losing their policies due to undisclosed inspection practices,” Calderon said. Concerns Over Aerial Imaging Aerial imaging has become a widely used tool in the insurance industry for assessing property risk and processing claims. However, many policyholders have expressed concerns over coverage losses tied to aerial photos taken without their knowledge. Upcoming Committee Hearing AB 75 is scheduled for a hearing before the Assembly Insurance Committee on Wednesday at 9:30 a.m. (PST). If passed, the bill could introduce greater accountability in insurer inspections and provide homeowners with a clearer understanding of how aerial imagery affects their policies. Source: Insurance Journal FAQs: California Bill on Insurance Aerial Inspections What does the new California bill require from insurers? The bill requires insurance companies to notify homeowners at least 30 days before conducting aerial imaging inspections. How will the California bill affect policyholders? It provides homeowners with transparency and access to aerial photos used in risk assessments, helping them protect coverage. Why was the California bill introduced? It was introduced to address rising non-renewals and cancellations, ensuring homeowners are not blindsided by inspection practices. When will the California bill be reviewed? The bill is scheduled for a hearing before the Assembly Insurance Committee, where lawmakers will determine its progress. Stay updated on major insurance reforms and fraud cases shaping the future of coverage. Subscribe to JacobiJournal.com for weekly legal and insurance news. 🔎 Read More from JacobiJournal.com:
CA Plumbing Contractor Fined $1M for Workers’ Comp Fraud
April 3, 2025 | JacobiJournal.com — A California plumbing contractor fined $1 million in restitution has been ordered to compensate the State Compensation Insurance Fund after admitting to a long-running workers’ compensation insurance fraud scheme. Prosecutors said the case highlights how underreporting payroll to reduce insurance premiums not only cheats the system but also puts employees at financial and medical risk when workplace injuries occur. The contractor, identified as Daniela G. Birdwell, 41, of GPS Plumbing, pleaded guilty after a state investigation uncovered millions in unreported payroll. Authorities say the restitution order is intended to recover losses sustained by the insurance system and to send a strong deterrent message to other employers who may consider similar practices. Fraud Discovery and Investigation Authorities reported that Daniela G. Birdwell, the owner of GPS Plumbing, carried out the scheme by intentionally misrepresenting payroll records, allowing her to significantly reduce the workers’ compensation insurance premiums owed by her company. The State Compensation Insurance Fund’s Special Investigation Unit (SIU) began reviewing GPS Plumbing after identifying discrepancies between payroll data reported to the Employment Development Department (EDD) and the information submitted during insurance policy audits. A deeper audit revealed that millions in payroll had gone unreported, exposing a scheme that not only placed workers at risk but also shifted financial burdens onto the state’s compensation system. The SIU then referred the case to the San Diego County District Attorney’s Office and the California Department of Insurance for prosecution. Legal Consequences Birdwell pleaded guilty to a felony count of workers’ compensation premium fraud. As part of the sentencing, the court imposed: Deputy District Attorney David Bagheri, who led the prosecution, emphasized that such cases highlight the importance of protecting workers and ensuring fair contributions to the state insurance fund. The ruling serves as a warning to other business owners that intentional underreporting of payroll to reduce premiums can lead to severe financial and legal consequences. Broader Impact on Workers’ Compensation Enforcement Cases like this underscore California’s commitment to enforcing workers’ compensation laws and deterring fraud that undermines the insurance system. By holding employers accountable, the state seeks to ensure that workers injured on the job receive proper benefits while maintaining fairness for businesses that comply with the law. Source: Insurance Journal FAQs: California Plumbing Contractor Fined Why was the California plumbing contractor fined? She was fined for underreporting payroll to reduce workers’ compensation insurance premiums, which is considered insurance fraud. How much restitution did the plumbing contractor have to pay? The court ordered her to pay $1 million in restitution to the State Compensation Insurance Fund. What penalties did the plumbing contractor receive besides restitution? She received two years of felony probation, 320 hours of community service, and structured monthly restitution payments. What does this plumbing contractor fraud case mean for other employers? It reinforces that fraudulent payroll reporting can lead to criminal charges, large financial penalties, and reputational damage. What are the penalties for a plumbing contractor convicted of workers’ compensation fraud in California? Penalties can include felony probation, community service, restitution payments, and in more severe cases, prison time. Contractors may also face loss of licenses and long-term reputational damage. Stay informed on major insurance fraud prosecutions, enforcement actions, and compliance updates. Subscribe to JacobiJournal.com for weekly coverage on fraud, law enforcement, and public integrity cases. 🔎 Read More from JacobiJournal.com:
Iowa Man Gets 10 Years for Fake Rolex Theft Insurance Scam
April 2, 2025 | JacobiJournal.com — An Iowa resident has been sentenced to 10 years in prison for orchestrating a fake Rolex theft insurance scam. Bryce Douglas Murphy, 33, of Peosta, pleaded guilty to Insurance Fraud and Fraudulent Practice, both Class D felonies. His conviction followed an investigation by the Iowa Insurance Division’s Fraud Bureau, which uncovered a repeated pattern of false claims. Bryce Douglas Murphy, 33, of Peosta, pleaded guilty to Insurance Fraud and Fraudulent Practice, both Class D felonies. Investigators from the Iowa Insurance Division’s Fraud Bureau uncovered the scam, leading to his conviction. The Counterfeit Rolex Scheme Murphy reported that two Rolex watches were stolen from his hotel room while attending an NFL game, supporting the claim with falsified receipts and documents. Investigators later determined that the supposed luxury watches were counterfeit and that the paperwork had been forged. Further inquiry revealed that this was not Murphy’s first attempt. In 2019, he filed a nearly identical claim with a different insurer and fraudulently obtained nearly $10,000. This history of deception ultimately strengthened the case against him. Authorities arrested Murphy on June 12, 2023. Sentencing and Penalties After entering a guilty plea, Murphy was sentenced to 10 years in state prison and ordered to pay $2,395 in fines. Authorities noted that this sentence reflects Iowa’s commitment to deterring fraudulent insurance activity. The Iowa Insurance Division emphasized that insurance fraud increases costs for all consumers and that its Fraud Bureau will continue aggressively investigating similar cases. Why This Case Matters Cases like the fake Rolex theft scam highlight how fraud undermines trust in the insurance system. Law enforcement agencies across the U.S. are stepping up prosecutions of individuals attempting to profit from fraudulent schemes, especially those involving counterfeit luxury goods. Source: Iowa Insurance Division FAQs: Fake Rolex Theft What is a fake Rolex theft insurance scam? A fake Rolex theft scam occurs when someone files an insurance claim for luxury watches that are either counterfeit or never stolen, using fabricated receipts and false reports. What penalties did the Iowa man face for the fake Rolex theft scheme? He was sentenced to 10 years in prison and ordered to pay $2,395 in fines after pleading guilty to insurance fraud and fraudulent practice. How did investigators uncover the fake Rolex theft fraud? Authorities compared receipts, examined the watches’ authenticity, and discovered that Murphy had previously filed a nearly identical fraudulent claim in 2019. Why is insurance fraud involving fake Rolex thefts taken seriously? Such fraud drives up insurance costs for honest policyholders, damages insurer trust, and involves deliberate forgery and deception, making it a prosecutable felony. Stay updated on the latest fraud cases and legal actions. Subscribe to JacobiJournal.com for breaking updates and in-depth coverage. 🔎 Read More from JacobiJournal.com:
Florida’s Universal P&C Fined $4M for Inflated Hurricane Irma Claims
April 2, 2025 | JacobiJournal.com — Hurricane Irma Settlement: Florida’s Universal Property & Casualty Insurance Co. must pay a $4 million fine after a state investigation found the insurer submitted ineligible claims to Florida’s Hurricane Catastrophe Fund (Cat Fund). The settlement prevents Universal from collecting more than $30 million in disputed reimbursements tied to Hurricane Irma. Investigation and Settlement Florida Attorney General James Uthmeier announced the settlement on Tuesday, citing findings from a whistleblower lawsuit. Investigators discovered that Universal had backdated claims from Hurricane Irma in 2017 to increase reimbursements. “Insurance fraud harms Floridians, and this case ensures that the Cat Fund only pays for legitimate storm-related losses,” Uthmeier said. Universal, based in Fort Lauderdale, denied any wrongdoing. Company officials argued that the claims had gone through the Cat Fund’s standard review process over six years. “The Cat Fund conducts a thorough commutation process, evaluating loss data to determine final settlements,” Universal stated. “This process applies to all insurers and led to a mutual agreement.” Whistleblower Lawsuit and Legal Costs A former Universal employee filed the whistleblower lawsuit in 2020, two years after leaving the company. Universal claimed the whistleblower misunderstood reporting procedures, leading to inaccurate allegations. The lawsuit, filed in Leon County, remains sealed. Florida’s Universal P&C Fined Under the settlement terms, Universal must pay $6.5 million, which includes $2.4 million in attorney fees. Universal’s Chief Strategy Officer, Arash Soleimani, framed the settlement as a mutual decision to dismiss the case and move forward. Industry Reactions and Market Impact Gina Wilson, the Cat Fund’s chief operating officer, did not comment on the settlement. However, industry insiders acknowledged that such claim adjustments are rare but not unheard of. Universal, one of Florida’s largest property insurers, explained that post-hurricane claim assessments often evolve. “Over time, insurers gain more information about losses,” Universal stated. “Some claims initially linked to hurricanes may later be classified as unrelated, while others previously omitted may be added.” The company reassessed about 1% of its Hurricane Irma claims before and during the commutation process. The storm remains Universal’s largest single loss event, with total costs rising from an initial $450 million estimate to more than $2 billion. Universal Moves Forward With the case now closed, Universal’s CEO, Stephen Donaghy, emphasized the company’s commitment to Florida policyholders. “We are pleased this review has concluded, and the state has dismissed the case,” Donaghy said. “As market reforms take effect, we look forward to providing more affordable home insurance options for consumers.” Despite the settlement, Universal Insurance Holdings’ stock remained near a five-year high, showing minimal impact from the announcement. For further details, see the Florida Attorney General’s Office announcement on insurance fraud enforcement. FAQs: Hurricane Irma Insurance Fine Why was Universal P&C fined over Hurricane Irma claims? Universal was fined $4M after investigators found the insurer had backdated Hurricane Irma claims to inflate reimbursements from Florida’s Cat Fund. How much did Hurricane Irma ultimately cost Universal P&C? Hurricane Irma remains Universal’s largest loss event, with costs exceeding $2 billion, far above the initial $450 million estimate. What role did the whistleblower lawsuit play in the Hurricane Irma settlement? A former Universal employee filed the whistleblower lawsuit, alleging the company misreported Hurricane Irma claims, leading to the state’s investigation. How does the Hurricane Irma case affect Florida homeowners today? The settlement ensures the Cat Fund pays only for legitimate Hurricane Irma claims, helping stabilize the insurance market and protect policyholders. Stay informed on major fraud cases and insurance industry updates. Subscribe to JacobiJournal.com for expert coverage delivered straight to your inbox. 🔎 Read More from JacobiJournal.com:
Public Adjuster Pleads Guilty to Defrauding Church After Hurricane
April 1, 2025 | JacobiJournal.com — Public Adjuster pleads Guilty: Andrew Aga, a public adjuster already serving time for defrauding Louisiana and Texas residents, pleaded guilty last week to defrauding Brotherhood Mutual Insurance Co. and a Georgia church. He stole millions after Hurricane Michael struck in 2018. The Fraudulent Scheme Aga, also known as Andrew Mitchell, defrauded Friendship Missionary Baptist Church in Albany, Georgia. The hurricane caused extensive damage, and Brotherhood Mutual Insurance paid the church $183,208 for repairs. A few days later, Aga and a construction company arrived, offering to maximize the settlement. Aga, affiliated with various companies like Loss Consultants of Texas and Mitchell Adjusting International, convinced Brotherhood Mutual to send him over $6 million. He forged the church leaders’ signatures and kept a portion of the funds, forwarding only about one-third to the church. Public Adjuster Pleads Guilty Background and Previous Convictions Aga, from Kemah, Texas, had a history of fraudulent schemes. He targeted homeowners, churches, and others across Louisiana and Texas, stealing millions. In 2023, he received a 20-year prison sentence for previous scams. Aga also left much of the church’s repair work unfinished. When the church questioned him, he falsely claimed the insurance company had withheld payments. Legal Consequences As part of his plea agreement in Georgia federal court, Aga faces up to 30 years in prison, restitution, and a $1 million fine. A Shocking Betrayal Acting U.S. Attorney Shanelle Booker expressed shock at the betrayal, particularly targeting a place of worship in the aftermath of a disaster. “The congregation trusted the defendant to help them repair their historic facility,” she said. The Role of the Georgia Insurance Commissioner Georgia Insurance Commissioner John King criticized Aga for exploiting victims already struggling with Hurricane Michael’s aftermath. Investigators held Aga accountable, ensuring justice for the church. Aga’s License and Final Words Aga, listed as a non-resident public adjuster in Georgia, had his license expire in 2022. Despite his criminal activities, he continued operating until authorities convicted him. Source: Full Article by The Insurance Journal FAQs: Public Adjuster Pleads Guilty Why did the public adjuster plead guilty in Georgia? He admitted to defrauding Brotherhood Mutual Insurance and a Georgia church after Hurricane Michael by forging documents and misusing funds. How much money was involved when the public adjuster pled guilty? The scheme involved over $6 million, with the church only receiving about one-third of the insurance settlement. What penalties does the public adjuster face after pleading guilty? He faces up to 30 years in federal prison, restitution payments, and a $1 million fine. Did the public adjuster who pled guilty have prior convictions? Yes, he previously received a 20-year sentence in 2023 for defrauding residents in Louisiana and Texas. Stay informed on insurance fraud cases and public corruption updates — subscribe to JacobiJournal.com today. Read More Articles:
Sugar Executive Charged With Stealing $28 Million From Mars Inc.
April 1, 2025 | JacobiJournal.com — Sugar Executive Charged: Paul Steed, a respected sugar market expert for Mars Inc., has been arrested and charged with stealing over $28 million from the candy giant. The 58-year-old from Stamford, Connecticut, stands accused of embezzling funds since 2013 through various fraudulent schemes. The Allegations Against Steed Steed, a dual U.S. and Argentine citizen, faces seven counts of wire fraud and two counts of tax evasion. Federal prosecutors allege that he diverted company funds to personal companies he set up, including Ibera LLC and MCNA LLC. From 2012 to 2020, Steed submitted false invoices from Ibera LLC to Mars, allegedly stealing nearly $580,000. Later, in 2016, Steed used MCNA to reroute millions of dollars from Mars, including over $11 million from the sale of Mars’s shares. Sugar Executive Charged Steed’s Lifestyle and Assets Steed’s lavish lifestyle raised red flags. Despite earning a $200,000 annual salary, he and his wife, Martina, lived beyond their means. They paid $2.5 million in cash for a Greenwich, Connecticut, property in 2023, and owned a $1 million home in Stamford. The judge’s detention order also revealed that Steed sent $2 million to Argentina over several years. He reportedly owns a cattle and tea ranch there. Mars Responds to Allegations Mars Inc. issued a statement condemning Steed’s actions as a betrayal by a single individual. The company emphasized its cooperation with law enforcement to resolve the issue swiftly while reaffirming its commitment to ethical standards in all its operations. Steed’s Role in the Industry Steed, now the executive charged in the Mars Inc. fraud case, was once considered a respected figure in the sugar industry. He served on national advisory boards, including the U.S. Agriculture Trade Advisory Committee for Sweeteners, and previously led the New York Sugar Club. Legal Proceedings Steed pleaded not guilty in federal court in Bridgeport and was ordered detained pending trial. The government has seized $18 million of the stolen funds, but several million dollars remain unaccounted for. Source: Insurance Journal – Full Article FAQs: Sugar Executive Charged Why was the sugar executive charged in the Mars Inc. case? He allegedly embezzled over $28 million through false invoices and shell companies. How long did the fraud by the executive last? Federal prosecutors say the schemes ran from 2012 to 2020. What assets did authorities seize from the executive? The government seized $18 million, though several million remain unaccounted for. What legal penalties could the executive face? He faces seven counts of wire fraud, two counts of tax evasion, and a lengthy federal prison sentence if convicted. Stay informed on major fraud investigations and corporate accountability cases — subscribe to JacobiJournal.com today. Read More Articles:
Miami Insurance Broker: Sentenced for Condo Premium Loan Fraud
March 28, 2025 | JacobiJournal.com — A federal judge has sentenced Miami insurance broker Heleonel “Leo” Gonzalez to 41 months in prison and ordered him to pay more than $5 million in restitution. Gonzalez defrauded a Georgia credit union by securing loans intended for condo associations’ insurance premiums and then misusing the funds for personal gain. Details of the Fraud Scheme Gonzalez, 48, owned Sharp Insurance Agency in Miami Lakes. Between 2023 and early 2024, he submitted false premium finance agreements to P1 Finance, a division of Peach State Federal Credit Union. He falsely claimed that condo associations had authorized these loans to cover property insurance premiums. Court records show that Gonzalez used these proceeds to settle personal debts and purchase property in Park City, Utah. Prosecutors highlighted that Peach State Federal Credit Union transferred around $6 million, unaware of the fraudulent representations. Miami Insurance Broker Condo Crisis Provided Cover for the Scheme Florida’s ongoing property insurance and condominium crises likely provided a cover for Gonzalez’s scheme. Condo insurance premiums and repair costs have surged, forcing many unit owners to consider relocating. Legislative changes in 2022 mandated frequent inspections and larger cash reserves, further straining associations’ finances. Prosecution and Sentencing Gonzalez pleaded guilty in November and voluntarily surrendered to the Bureau of Prisons. Prosecutors noted that his sentence was less than the maximum allowed by sentencing guidelines and fell below their recommendation. He also faces asset forfeiture, including the Park City property. Gonzalez’s Ties to Insurance Providers Records from the Florida Department of Financial Services show that Gonzalez had been an agent for Citizens Property Insurance Corp. since 2016. His appointment is set to expire in April 2025. He also held active appointments with 15 other insurers. Sharp Insurance Agency’s Current Status Despite his sentencing, Gonzalez was still listed as president on the Sharp Insurance Agency’s website as of Thursday. Source: Insurance Journal – Full Article FAQs: Miami Insurance Broker Sentencing Why was the Miami insurance broker sentenced in 2025? The Miami insurance broker, Leo Gonzalez, was sentenced for defrauding a Georgia credit union by misusing condo premium finance loans. How much restitution must the Miami insurance broker pay? Gonzalez was ordered to pay more than $5 million in restitution after his conviction. What role did the condo crisis play in the Miami insurance broker case? Florida’s condo insurance and repair cost crisis created conditions that helped conceal Gonzalez’s fraudulent scheme. Did the Miami insurance broker lose his insurance licenses? Records show Gonzalez held active appointments with Citizens Property Insurance Corp. and 15 other insurers, with expirations pending in 2025. Stay informed on insurance fraud cases and financial crime updates — subscribe to JacobiJournal.com today. 🔎 Read More from JacobiJournal.com:
Texas Medicaid Insurer: Probed for Alleged Surveillance
March 28, 2025 | JacobiJournal.com — Texas Medicaid Insurer: Texas Attorney General Ken Paxton has launched an investigation into Superior HealthPlan, a Medicaid insurance provider, after allegations surfaced that the company illegally spied on lawmakers, journalists, and private citizens. Allegations of Blackmail and Surveillance Superior HealthPlan, which offers Medicaid and Children’s Health Insurance Program (CHIP) coverage in Texas, allegedly used private investigators to perform surveillance and gather confidential information. The targets included lawmakers and other influential Texans. Paxton expressed concern that the company’s actions aimed to blackmail lawmakers to secure state contracts and avoid paying legitimate claims. Texas Medicaid Insurer CEO Questioned, Then Fired On Wednesday, Superior HealthPlan CEO Mark Sanders testified before the Texas House Committee on the Delivery of Government Efficiency. He admitted that the company had used private investigators but claimed they had stopped the practice years ago. However, after intense scrutiny from lawmakers, Sanders was fired on Thursday, according to the Dallas Morning News. Lawmakers Condemn Superior’s Actions Lawmakers expressed outrage over the company’s conduct. State Rep. Tony Tinderholt (R-Arlington) called the practice “disgusting.” Similarly, Rep. David Cook (R-Mansfield) questioned why Superior HealthPlan investigators had looked into legislators’ divorce records. Sanders failed to provide a clear explanation. “We’re talking to a company that received billions in taxpayer funds through Medicaid contracts,” said Rep. Ellen Troxclair (R-Lakeway). “That money was used to hire private investigators to follow patients and legislators. It’s ridiculous.” Bill Filed to Prohibit Surveillance by State Contractors In response, state Rep. Jeff Leach filed House Bill 5061 earlier this month. The bill seeks to prohibit any state contractor from engaging in surveillance, aiming to prevent similar incidents in the future. Impact on Texans’ Medicaid Coverage Tiffany Young, a spokesperson for Texas Health and Human Services, referred questions about the investigation’s impact on Medicaid coverage to Paxton’s office. However, the attorney general’s office has yet to respond to inquiries. Source: The Texas Tribune – Full Article FAQs: Texas Medicaid Insurer Why is the Texas Medicaid Insurer Superior HealthPlan under investigation? Superior HealthPlan is under investigation for allegedly using surveillance and private investigators to target lawmakers, journalists, and citizens. How could the Texas Medicaid Insurer case affect Medicaid coverage in Texas? While officials say Medicaid services remain active, the probe raises concerns about trust, contract oversight, and patient protections. What actions are lawmakers taking against the Texas Medicaid Insurer? Lawmakers filed House Bill 5061 to prohibit state contractors, including Medicaid insurers, from conducting surveillance. Who oversees accountability for the Texas Medicaid Insurer contracts? The Texas Health and Human Services Commission oversees Medicaid contracts, while the Attorney General investigates potential misconduct. Stay Updated: For the latest developments on insurance fraud and state investigations, visit JacobiJournal.com. Read More from JacobiJournal.com