CRMBC investigation leads to arrest of suspect on 5 Felony Counts of Fraud

SACRAMENTO, Calif., May 2, 2012 /PRNewswire/ -- The California Restaurant Mutual Benefit Corporation (CRMBC) announced today that the Los Angeles County District Attorney has arrested Emmanuel de Paz on three felony counts of insurance fraud and two felony counts of attempted perjury in connection to an alleged work injury filed as an employee of the El Gallo Giro Corporation. 

CRMBC's anti-fraud and abuse program managed by claims administrator American Claims Management (ACM) and deployed by investigation firm J.D. Wesson & Associates led to de Paz's arrest. After an initial investigation, conducted by Investigation Solutions and surveillance company Immendorf & Company, it is alleged that de Paz had been working for a Jack in the Box restaurant while collecting benefits for an injury reported to have incurred in June of 2011, while serving as an employee of the El Gallo Giro Corporation.

"Fraudulent activity by a small fraction of providers and employees costs California employers several millions of dollars each year, squeezing small businesses and adding to job loss," said David Mitchell, Chair of the CRMBC Board of Trustees. "Fraud in Workers' Compensation is harmful to the great majority of honest employers, employees and doctors and our ability to root out the problem of fraud is crucial in protecting this majority."

Investigators provided surveillance footage in support of the allegation to the Los Angeles County District Attorney in February of this year. ACM had denied the claim at the El Gallo Giro Corporation based on an employer investigation and witness statements. Subsequently, de Paz litigated the claim, alleging injuries to multiple body parts as well as a psychiatric claim.  Mr. de Paz subsequently withdrew this claim. Arraignment for de Paz is scheduled for May 9.

The California Restaurant Mutual Corporation is the largest self-insured group for Workers' Compensation in California.

SOURCE California Restaurant Mutual Benefit Corporation (CRMBC)