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Home » Crime » This Article

Chiropractor, Claims Adjustor Charged in Alleged Insurance Fraud Scheme

Posted by Contributing Editor on October 28, 2020 in Crime | Leave a response
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A chiropractor and a claims adjustor were arrested Wednesday in connection with an alleged $1.6 million insurance fraud scheme, authorities said.

Shahe Kevork Topjian, 65, of Granada Hills, and Agop Sarafian, 65, of La Crescenta, were taken into custody by investigators from the California Department of Insurance.

The two — who are charged with one felony count each of insurance fraud — allegedly defrauded the State Compensation Insurance Fund by setting up fake workers’ compensation lien settlements to receive insurance payouts, according to the Los Angeles County District Attorney’s Office.

Prosecutors allege the crimes occurred between June 2007 and November 2019.

The state fund — where Sarafian was employed — launched an internal investigation dubbed “Operation Lien on Me” last year after another employee noted a suspicious lien payment issued by Sarafian, and investigators determined that he had processed 459 lien payments to Topjian over a 12-year period, according to the Department of Insurance.

Liens are often submitted by a physician or provider for payment to which they believe they are entitled from a claimant’s workers’ compensation treatment or for services rendered, according to the Department of Insurance.

The DOI said its investigation revealed that Sarafian created and approved the lien payments for Topjian by using past workers’ compensation claims he had worked on to create the fraudulent lien payments for services that were never provided.

Sarafian allegedly processed the lien payments under his $5,000 approving authority limit to avoid outside approval, and the payments were sent to Topjian and a portion was given to Sarafian, the DOI alleges.

“These trusted professionals conspired to illegally line their own pockets for over a decade,” state Insurance Commissioner Ricardo Lara alleged. “Their actions not only defrauded money from State Fund, but also harmed California consumers who pay for this type of fraud through higher insurance premiums.”

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The two could each face a maximum of five years in county jail if convicted as charged, prosecutors said.

Chiropractor, Claims Adjustor Charged in Alleged Insurance Fraud Scheme was last modified: October 28th, 2020 by Contributing Editor

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Posted in Crime | Tagged Adjustor, alleged, charged, chiropractor, claims, fraud, Insurance, Scheme

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