Orange County prosecutors filed charges Monday against 16 defendants, including 10 attorneys, who targeted Spanish-speaking clients in an alleged scheme to bilk workers’ compensation insurance companies out of at least $300 million over three years.
Carlos Arguello III, 35, of Tustin, and Edgar Gonzalez, 50, of Anaheim, are the alleged “masterminds” of the ring that illegally recruited workers’ comp clients in the Latino community, according to Orange County District Attorney Tony Rackauckas.
The so-called cappers — which is a legal term used often for recruiters — went looking for clients, attorneys and doctors to get involved in the alleged scheme, Rackauckas said. It is illegal to solicit legal business in that way, the prosecutor said.
Under the alleged scheme that involved at least 33,000 patients from June 2011 through April 2014, insurance companies were billed for about $300 million, said Deputy District Attorney Noor Hasan. But there are likely many more patients and losses to insurance companies since 2014, she said.
The illegal recruiting would often start with fliers placed on windshields of vehicles at swap meets or other places where crowds gathered, Hasan said. The cappers would also hand out business cards, she said.
Potential clients would dial the toll-free number on the cards and be connected to a call center in El Salvador, Rackauckas said. The dispatcher would then send someone out to the caller’s home to pressure him or her into signing paperwork for workers’ comp claims and retainer agreements with attorneys involved in the scheme, Rackauckas said.
Another phase of the investigation, which is still active, will likely involve charges against physicians allegedly involved in the scam, Rackauckas said.
There’s nothing wrong with an attorney taking out ads and signing up clients for services, but it is illegal to actively solicit business in this fashion, Rackauckas said.
Hasan said her investigators saw a “trend” of some clients being targeted in governmental agencies because the oversight on the workers’ comp claims is not as robust as it is with private companies.
The attorneys would receive $1,500 per deposition and nine to 20 percent of any settlement, Rackauckas said.
The investigation was triggered when insurance companies saw a large volume of claims coming in with paperwork that appeared to be done on a mass, generic scale, Rackcauckas said.
He characterized it as an “insurance fraud factory” and said the defendants “targeted the Hispanic community, using them like an ATM machine.”
The other alleged cappers charged in the case are:
— Boris Mikhayovich Dadiomov, 31, of San Diego;
— Soraida Veronica Castro, 42, of Imperial Beach;
— Tania Arguello-Plasencia, 31, of Tustin; and
— Duke Gallegos, 30, of San Ysidro.
The attorneys charged in the case are:
— Jon Woods, 56, of Cypress;
— Payman Zargari, 49, of Sherman Oaks;
— John Jansen, 49, of Santa Ana;
— Fari Rezai, 39, of Irvine;
— Lionel Eduardo Giron, 49, of Pomona;
— Dennis Ralph Fusi, 73, of Lakewood;
— Jorge Humberto Reyes, 39, of Los Angeles;
— Rony M. Barsoum, 43, of Los Angeles;
— Robert Irving Slater, 67, of Encino; and
–Robin Jacobs, 52, of Sherman Oaks.
The charges include conspiring to refer clients for compensation, referring patients and clients with reckless disregard for commission of fraud and insurance fraud.
Arguello faces up to 29 years and eight months in prison if convicted, while Gonzalez would faces up to 20 years and eight months behind bars.
–City News Service
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