Annual Report 2006 - San Diego County District Attorney

Provider Fraud Task ForceThe Insurance Fraud Division also has a Medical andLegal Insurance Fraud Task Force which investigatesand prosecutes medical and legal providerscommitting insurance fraud. The unique nature ofthis task force, the first of its kind in the nation, isthat we have combined federal, state, and countyagencies together into one cohesive unit.These unfair practices enable unscrupulousemployers to underbid honest competitors. Thisresults in honest employers losing jobs andultimately driving them out of business.San Diego’s Premium Fraud Task Force helpsmaintain a level playing field by prosecutingbusinesses that commit premium fraud. This TaskForce is comprised of the following agencies: DistrictAttorney’s Office; Labor Commissioner; EmploymentDevelopment Department Criminal Investigationsand Tax Enforcement; Franchise Tax Board;Department of Insurance; Bureau of AutomotiveRepair; and the Contractors State LicensingBoard. The Task Force works very closely with theinsurance industry including State CompensationInsurance Fund (SCIF) which is the largest workers’compensation carrier in California.In 2006, the division’s Task Force prosecuted thelargest premium fraud case ever handled in SanDiego. A roofing company working throughoutSouthern California and in Fresno misclassified theiremployees’ rate of pay to SCIF for three years. TheTask Force served 15 search warrants in San Diego,Los Angeles, and Riverside Counties, seizing 187 boxesof evidence and 45 computers. The owners of theroofing company were indicted by the Grand Juryfor premium fraud after the Task Force producedwitnesses from the counties of San Diego, LosAngeles, Riverside, San Bernardino, Ventura, andImperial. The owners pled guilty to felony premiumfraud and paid, in full, restitution of more than $3million to State Fund. This is the largest amount ofrestitution our division has ever collected in one case.Members include: District Attorney staff;Department of Insurance; Franchise Tax Board;FBI; the California Department of Justice; the U.S.Department of Health and Human Services; theMedical Board; the California State Bar; CaliforniaDepartment of Health Services; CaliforniaDepartment of Industrial Relations; U.S. Office ofPersonnel Management; U.S. Postal Service; U.S.Department of Defense; and the Dental Board.Life And Annuity ConsumerProtection ProgramIn 2006, the division established a new Life andAnnuity Protection Program to investigate andprosecute unscrupulous life insurance agents andothers who seek to steal the savings of victimsthrough power of attorney abuse and fraudulentclaims upon a legitimate policy. San Diego Countywas only one of four counties in the state ofCalifornia to receive funding for this new program.Life insurance and annuity scams are often targetedat senior citizens. The effect is profound and life-NATIONAL ASSOCIATION OFCOUNTIES 2006 ACHIEVEMENTAWARDSPROVIDER FRAUD TASK FORCEHonored for implementing an effectiveand creative program that promotesresponsible, responsive and effectivecounty government.322006 Annual Report