Jacobi Journal of Insurance Investigation

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

Texas Insurance Fraud Investigations: The Texas Department of Insurance’s (TDI) Fraud Unit successfully recovered nearly $58 million in court-ordered restitution last year, targeting major fraud cases that impact insurance companies and consumers alike.

TDI’s Aggressive Fraud Crackdown

More than 20 investigators across Texas examined over 350 insurance fraud allegations, prioritizing cases with the highest financial impact. By cracking down on fraudulent claims, the agency aims to prevent premium hikes for policyholders.

“If we recoup restitution for insurance companies and consumers, hopefully that causes less of an increase in premiums,” said TDI attorney Kyson Johnson. “Those companies and consumers are no longer exposed to the fraud.”

Dallas Doctors Caught in Fraud Scheme

Texas Insurance Fraud Investigations: One high-profile investigation led to the takedown of Dallas-based doctors Desi and Deno Barroga. The duo, both 51, were indicted in November 2023 and pleaded guilty in May 2024 to conspiracy to commit healthcare fraud. They had been overprescribing opioids and falsely billing health plans for millions of dollars.

“These doctors exploited drug users’ vulnerabilities, requiring them to submit to monthly visits in exchange for controlled substance prescriptions, then billing their insurance providers for services the patients did not need nor receive,” said U.S. Attorney Leigha Simonton in September 2024. “In a bizarre attempt to cover up their crimes, the defendants feigned giving injections without actually piercing the patients’ skin.”

A TDI investigator played a key role in assisting the FBI and other agencies in building a criminal case. As a result, a U.S. district judge sentenced the doctors to prison and ordered them to pay $9 million in restitution. Additionally, both were stripped of their medical licenses.

Fighting Fraud: A Call to Action

TDI encourages consumers to report suspected fraud by visiting TDI’s fraud reporting page.

For more updates on insurance fraud cases and industry trends, visit JacobiJournal.com.

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(Source: Texas Department of Insurance)

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