Jacobi Journal of Insurance Investigation

Unveiling the truth behind insurance claims.
Protecting integrity in every investigation.

Pepperdine University and Janitorial Contractors Cited for Labor Violations

Pepperdine University and Janitorial Contractors Cited for Labor Violations

May 07, 2025 | JacobiJournal.com – Los Angeles County, CA – The California Labor Commissioner’s Office has cited Pepperdine University and four janitorial contractors a combined $80,000 for violating state janitorial registration laws, raising concerns about labor compliance practices within higher education institutions. Unregistered Contractors Trigger Citations The investigation revealed that Pepperdine hired unregistered janitorial companies, a direct violation of California Labor Code Section 1432, which mandates annual registration for all janitorial employers. As a result: Watchdog Referral Sparked Inquiry The Maintenance Cooperation Trust Fund, a watchdog organization that monitors janitorial labor practices, referred the case to state authorities. Their referral led to a deeper investigation into Pepperdine’s hiring practices. Previously, Pepperdine had contracted with companies in compliance with registration laws. However, it later switched to vendors that failed to register, undermining labor protections designed to prevent worker exploitation. Companies Operated Across Multiple States The cited contractors operated both in California and out of state, with locations in: The Labor Commissioner emphasized the importance of maintaining compliance not just within California, but also for companies working across state lines. Source 📢 Stay Vigilant on Compliance This case underscores the risks of outsourcing to unvetted vendors. Educational institutions and private entities alike must ensure that all service providers meet state registration requirements to avoid legal exposure and protect workers’ rights. 🔎 Read More from JacobiJournal.com: 💼 Need to audit your vendor contracts for labor compliance?Stay current with California employment laws at JacobiJournal.com, your trusted source for legal updates, enforcement news, and workplace integrity.

Cupertino Electric Pays $1.4M in Back Wages for Labor Violations

Summary Judgment Motion Renewal Denied for Carrier

San Jose, CA – Cupertino Electric Inc., a prominent electrical engineering and construction firm, has paid $1.4 million after the U.S. Department of Labor uncovered significant violations of the Fair Labor Standards Act (FLSA). Over 2,600 Workers Impacted According to the Department’s Wage and Hour Division, the San Jose-based company failed to properly calculate overtime wages for more than 2,600 employees. Investigators discovered that Cupertino Electric did not include non-discretionary bonuses—such as production or performance-based incentives—when determining overtime pay rates. As a result, the company shortchanged workers on overtime compensation, prompting federal enforcement action. In response, Cupertino Electric paid both back wages and fines, totaling $1.4 million. Longstanding Industry Presence Cupertino Electric has a wide footprint, having built electrical systems for private and public sector clients across multiple states. While the company has maintained a reputation for large-scale infrastructure work, this case reveals systemic issues in its payroll practices. DOL Reinforces Employer Responsibilities “Employers must accurately calculate overtime pay and include all required compensation, such as bonuses, when determining the correct rate,” said a representative from the Department of Labor. “Failure to do so violates workers’ rights and creates unfair labor conditions.” This case serves as a reminder that even large firms are not exempt from compliance. Employers must regularly audit their payroll systems to avoid wage violations that could result in costly penalties. Source 🔎 Read More from JacobiJournal.com: 📢 Stay Informed, Stay Compliant JacobiJournal.com brings you the latest on labor law enforcement, fraud investigations, and workplace compliance. Visit us regularly for expert insights and updates on employer accountability.

Court Overturns $1.84 Million Jury Award for Work Injury Claim

Court Overturns $1.84 Million Jury Award for Work Injury Claim

A California appellate court has overturns $1.84 million jury verdict awarded to a subcontractor’s employee who was injured on the job. The ruling highlights the limits of liability for general contractors in workplace injury lawsuits. Worker Claimed Unsafe Conditions Caused Injury The injured worker sued the general contractor after falling through an unguarded skylight. He alleged that unsafe work conditions were to blame. A jury initially agreed and awarded him nearly $2 million in damages. Defense Challenged Liability However, the defense argued that the worker was not authorized to be in the area where he fell. They claimed he acted outside the scope of his job duties and ignored safety rules. The general contractor filed a motion for nonsuit, asserting they had no legal duty in this specific situation. Appellate Court Overturns Verdict On appeal, the court found that the general contractor did not owe the injured worker a duty of care. They emphasized that general contractors are not automatically responsible for the safety of subcontractor employees—especially when those employees violate safety protocols. Moreover, the court noted that the worker’s own employer bore primary responsibility for his supervision and safety. Broader Implications This decision may influence future workplace injury lawsuits in California. It clarifies that general contractors are not liable unless they directly control the worksite in a way that contributes to the injury. Therefore, injured workers must prove more than just unsafe conditions—they must show a clear duty of care. Source: Court Overturns $1.84 Million Jury Award for Work Injury Claim 🔎 Read More from JacobiJournal.com: ⚖️ Stay Ahead with JacobiJournal.com Get expert insights into legal trends, verdicts, and policy shifts affecting workers’ compensation law. Visit JacobiJournal.com for the latest updates and expert commentary on high-stakes litigation.

San Joaquin County DA Secures Felony Conviction in Workers’ Comp Fraud Case

San Joaquin County DA Secures Felony Conviction in Workers’ Comp Fraud Case

May 02, 2025 | JacobiJournal.com – Stockton, CA – The San Joaquin County DA Office has successfully obtained a felony conviction in a workers’ compensation fraud case, reinforcing its strong stance against insurance fraud and abuse in the region. Stacy Johnson pled guilty to two felony charges: Penal Code 487 (Grand Theft) and Penal Code 550(b)(3) (Insurance Fraud). As a result, he was sentenced to four months in County Jail, two years of felony probation, and ordered to pay $3,000 in investigative restitution and $2,000 to his former employer, Amazon, for the stolen goods. Faked Robbery and Fraudulent Claim According to prosecutors, Johnson conspired with others to stage a robbery of an Amazon delivery truck he was driving. He then filed a fraudulent workers’ compensation claim, falsely citing “physiological injuries and stress” as a result of the staged incident. If the fraud had not been detected, the false claim could have cost an estimated $35,000—a burden likely to be passed on to consumers through increased prices. DA’s Office Sends a Message District Attorney Ron Freitas emphasized the broader implications of such crimes, stating: “Workers’ compensation fraud is NOT a victimless crime—it affects all of us. It drives up costs for local businesses and raises prices for the goods we rely on every day.” Freitas added that the DA’s ongoing outreach campaign makes it clear: San Joaquin County will not tolerate workers’ comp fraud. Those who commit it will be prosecuted. Source: San Joaquin County DA Office 🔎 Read More from JacobiJournal.com: ✅ Stay Ahead of Workers’ Comp Fraud Trends Explore the latest case law, convictions, and enforcement efforts at JacobiJournal.com. We deliver expert insights to help professionals stay informed and protected.

Amazon Driver Sentenced for Workers’ Comp Fraud in Staged Robbery Scheme

Amazon Driver Sentenced for Workers’ Comp Fraud in Staged Robbery Scheme

Prosecutors Say Fraud Scheme Could Have Cost Amazon and Consumers Thousands April 25, 2025 | JacobiJournal.com – STOCKTON, Calif. — A former Amazon delivery driver has been sentenced to jail for orchestrating a fake robbery and filing a fraudulent workers’ compensation claim. Stacy Johnson, the driver, admitted to staging the incident in a failed attempt to collect benefits for stress and physical injuries that never occurred. Jail Time, Fines, and Probation Handed Down The San Joaquin County District Attorney’s Office announced that Johnson will serve four months in county jail. In addition, he will be on probation for two years and must pay $5,000 in financial penalties. This includes $2,000 in restitution to Amazon and $3,000 to reimburse investigative costs. “Workers’ compensation fraud is not a victimless crime,” said District Attorney Ron Freitas. “It directly impacts local businesses and ultimately drives up the cost of goods for all consumers.” How the Fraud Unfolded Amazon Driver Sentenced: According to investigators, Johnson staged the robbery of his own Amazon delivery truck and then filed a false claim for psychological trauma and physical ailments. However, the ruse quickly unraveled under scrutiny. Had the fraud gone undetected, Amazon would have paid nearly $35,000 in unwarranted benefits. More importantly, that financial burden would likely have been passed on to customers through higher retail prices. Crackdown on Workers’ Compensation Fraud Authorities have made it clear: San Joaquin County will not tolerate attempts to exploit the workers’ compensation system. As part of a broader campaign to eliminate insurance fraud, prosecutors are targeting these cases with renewed urgency. “This successful prosecution shows our ongoing commitment to exposing and stopping fraud,” Freitas added. “We will protect our workers and our economy.” Why It Matters Cases like this highlight how fraudulent claims can damage trust in legitimate systems. While the workers’ compensation program exists to support injured employees, abuse by a few undermines its credibility for all. Moving forward, local officials plan to continue public outreach efforts and collaborate with employers and insurers to stop similar schemes early.surance fraud: authorities are watching, and consequences will follow. Read More from JacobiJournal.com: 🔎 Stay informed about insurance fraud cases impacting workers’ comp systems and consumer prices.📲 Visit JacobiJournal.com for ongoing coverage, legal analysis, and expert commentary on fraud investigations nationwide. Source: San Joaquin County District Attorney’s Office

Workers’ Compensation Fraud Scheme Targeted Spanish-Speaking Workers in California

Texas Woman Sentenced for Disaster Relief Fraud Across Multiple States

Over $550,000 in Illegal Referral Fees Allegedly Collected by Attorneys in Statewide Scam April 25, 2025 | JacobiJournal.com – SAN BERNARDINO, Calif. — In a major crackdown, four individuals—among them two attorneys—face felony charges after investigators uncovered a large workers’ compensation fraud scheme aimed at Spanish-speaking workers across Southern California. The fraudulent operation allegedly netted over $550,000 in unlawful referral fees and compromised more than 1,100 legitimate injury claims. Investigation Reveals Call Center Operating Out of Mexico In October 2022, the California Department of Insurance launched a probe following reports that a call center based in Mexico was contacting Spanish-speaking workers with deceptive promises. These callers reportedly told individuals they could receive money by simply filing a workers’ compensation claim. However, investigators found that in many cases, victims were manipulated into signing official claims documents without full understanding. These completed claims were then illegally sold to attorneys in exchange for referral fees, violating California law. “This is a disturbing case of alleged fraud that preyed on vulnerable, hardworking people,” said Insurance Commissioner Ricardo Lara. “These crimes threaten the integrity of our workers’ compensation system and will not be tolerated.” Arrests and Charges Filed Against Four Defendants The Department of Insurance, in collaboration with the San Bernardino County District Attorney’s Office, arrested the following individuals: How the Scheme Unfolded From January 2022 to September 2023, Franco allegedly sold 320 clients to De La Garza and Leal for $168,750. Additionally, from September 2021 through October 2024, she sold 798 clients to Gluck for $388,500. Given that the average workers’ compensation claim costs approximately $13,000, according to the 2024 WCIRB report, the total projected loss from the scheme exceeds $14.5 million. Legal Action and System Integrity The San Bernardino County District Attorney’s Office is now prosecuting the case. Authorities emphasize the need to protect injured workers from exploitation, especially within immigrant and vulnerable communities. Read More from JacobiJournal.com: Stay ahead of emerging fraud trends in workers’ comp. Visit JacobiJournal.com for the latest updates and legal insights. Are you tracking workers’ compensation fraud in California? Bookmark JacobiJournal.com to stay informed on legal actions, scams, and systemic reforms. Source: California Department of Insurance

CAAA: Combating Fraud in the Workers’ Compensation System

CAAA: Combating Fraud in the Workers' Compensation System

April 24, 2025 | JacobiJournal.com – Fraud in the workers’ compensation system is a major concern for both employers and employees in California. The California Applicants’ Attorneys Association (CAAA) has been at the forefront of addressing these issues, advocating for reforms, and ensuring the protection of workers’ rights while maintaining the integrity of the system. The Scope of Workers’ Comp Fraud Fraud within the workers’ compensation system can take many forms. It can involve workers who exaggerate injuries or claim benefits they are not entitled to, as well as employers and medical providers who engage in deceptive practices to reduce their financial responsibilities or inflate claims. These fraudulent activities undermine the efficiency of the system and can have wide-reaching consequences for businesses and employees alike. The CAAA emphasizes the importance of addressing fraud not only through legal and regulatory measures but also by fostering a culture of transparency and accountability within the workers’ compensation process. Fraudulent claims can result in increased premiums for employers, ultimately affecting their ability to provide jobs and maintain operations. Additionally, workers may suffer as well, as fraudulent practices can delay legitimate claims, leading to unnecessary financial strain. Legal Protections and Reforms In response to growing concerns about fraud in the system, CAAA works closely with legislators to advocate for reforms that reduce fraudulent activities while still ensuring that workers who are legitimately injured receive the benefits they deserve. This includes advocating for more stringent vetting processes for medical providers, better oversight of claims processing, and stronger penalties for those caught committing fraud. The association also pushes for initiatives that educate workers about their rights and the claims process to help them avoid being targeted by fraudsters. CAAA’s ongoing efforts seek to strike a balance between protecting workers’ rights and ensuring that fraud does not undermine the workers’ compensation system. Combating Fraud in the Workers’ Comp System: What Employers Can Do Employers also play a key role in preventing workers’ compensation fraud. By implementing effective safety protocols, training employees on proper injury reporting procedures, and maintaining open communication with claims adjusters, employers can reduce the likelihood of fraudulent claims. Additionally, employers should actively participate in audits and investigations related to their workers’ compensation policies to identify potential fraudulent activities early. Conclusion: A Call for Action As the workers’ compensation system continues to evolve, tackling fraud remains a priority. The CAAA’s efforts to address this issue are crucial in ensuring a fair and functional system for all involved parties. By strengthening legal protections, promoting transparency, and fostering collaboration between employers, employees, and lawmakers, California can combat fraud effectively while safeguarding workers’ rights. Source Read More Articles from JacobiJournal: NY VA Firefighter Pleads Guilty to Workers’ Compensation Fraud Scheme Detroit CBP Director Charged in FEMA Fraud Scheme Employee Denied Workers’ Compensation for Topgolf Injury Healthcare Software Firm Pleads Guilty in $1B Medicare Fraud Scheme Stay updated on fraud-related issues and other workers’ comp news by visiting JacobiJournal.com. For more information, explore JacobiJournal.com.

Fresno Executives Sentenced in Pension, Workers’ Comp Fraud Case

Fresno Executives Sentenced in Pension, Workers’ Comp Fraud Case

April 17, 2025 | JacobiJournal.com – Fresno Executives Sentenced behind a long-running fraud operation will now serve time in federal prison. A U.S. District Court sentenced Marcus Asay, 69, and Antonio Gastelum, 53, for their roles in an elaborate scheme that targeted over 3,000 victims nationwide. Judge Dale A. Drozd sentenced Asay to five years and Gastelum to two years in prison. Their company, Agricultural Contracting Services Association—doing business as American Labor Alliance (ALA)—must also pay a $2.5 million fine. Additionally, both Asay and ALA owe $69,250 in restitution. Fraud Spanning Nearly a Decade A federal jury convicted the defendants in June 2024 after a five-week trial. Prosecutors proved that from 2011 to 2019, Asay and Gastelum orchestrated multiple fraudulent operations through ALA, including pension fraud, workers’ compensation fraud, and an Affordable Care Act (ACA) exemption scam. They also laundered money to cover their tracks. How the Pension Scheme Worked Asay and Gastelum promised clients that their retirement savings would grow through a 401(k) plan managed by ALA. However, instead of investing those funds, the duo diverted the money for personal use. They splurged on fine dining, rare coins, online companionship services, and rent for Asay’s upscale lakefront home in Fresno. To conceal the missing funds, they redirected revenue from their workers’ compensation scam and falsely labeled it as pension money. This manipulation led to over $620,000 in losses. Fresno Executives Sentenced Faking Workers’ Compensation Coverage In a separate scam, the defendants falsely claimed that national insurance carriers backed ALA’s workers’ comp policies. They issued forged certificates and policy declarations to customers in California and other states. Many businesses relied on those documents to stay compliant and retain contracts. Rather than admit wrongdoing, Asay actively discouraged customers from cooperating with investigators. Authorities later confirmed the policies had no backing from legitimate insurers. This part of the scheme brought in $2.25 million in premiums. Misleading Health Insurance Exemption Offers Additionally, ALA sold fake ACA hardship exemptions to consumers for hundreds of dollars. In reality, only the federal government can issue such exemptions—and qualified individuals can receive them at no cost. By misrepresenting this process, ALA exploited consumers who were seeking relief from healthcare penalties. Lies Under Oath Add to Their Sentences Both Asay and Gastelum took the stand in their defense. However, the court found they lied under oath, which resulted in longer prison sentences. Their perjury underscored their continued intent to deceive, even during trial. Broad Investigation, Federal Charges Federal agents from multiple agencies collaborated to bring the case to court, including: Assistant U.S. Attorneys Michael Tierney, Joseph Barton, and Stephanie Stokman led the prosecution, which ultimately held the perpetrators accountable. Source: USAO-EDCA Read More from JacobiJournal.com Stay informed with the latest updates on insurance fraud, workers’ compensation violations, and more at JacobiJournal.com.

New York Inspector Uncovers $2.7M Workers’ Comp Fraud in 2024

New York Inspector Uncovers $2.7M Workers’ Comp Fraud in 2024

April 17, 2025 | JacobiJournal.com – ALBANY, NY – Workers’ compensation fraud in New York 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. 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 Read More from JacobiJournal.com Stay informed on workers’ compensation fraud and regulatory enforcement at JacobiJournal.com.

LA Couple Sentenced for Underreporting Payroll, Filing False Workers’ Comp Claims

Long Island School District Sues Insurers Over Abuse Allegations

April 15, 2025 | JacobiJournal.com – LOS ANGELES – 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. 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. LA Couple Sentenced 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. 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 Read More from JacobiJournal.com Stay updated on fraud investigations and workers’ compensation cases at JacobiJournal.com.