Maria Garcia alleged an industrial injury to her head, neck, back, feet, and convulsions resulting from a fall that occurred while working as a Deli Clerk for R-Ranch Markets. Witnesses noted suspicions based on observations during the incident. VRC Investigations obtained recorded statements of the witnesses and reviewed the employer’s in-house surveillance footage and secured it for chain of evidence.
In-house surveillance footage depicted Garcia staging the area right before her alleged fall, arranging objects around her, calling coworkers for help, and then convulsing after coworkers arrived. The film further depicted the convulsions stopped right before a coworker was about to put a belt in her mouth.
VRC’s Special Investigation Unit packaged the suspected fraud case and presented the evidence it to the Los Angeles County District Attorney, who conducted a criminal investigation of Garcia. The Los Angeles County District Attorney filed criminal charges; Garcia was charged with 1 Felony count of CA Insurance Fraud Code 1871.4. In September 2020, Garcia pled guilty and was convicted of felony insurance fraud, sentenced to 3 days in custody, 3 years of formal probation, 100 hours of community service, and ordered to pay $23,720 in restitution. The restitution included the cost of the investigation to make the victim whole.
If you suspected a WC claim is not legitimate, alert your SIU partner to coordinate an immediate investigation to help ensure only warranted benefits are paid. Fraud referrals should be made on suspicious fraudulent cases even when the claim has been denied, as an attempted theft is no less of a crime than an actual theft. Please contact me to discuss our customized fraud abatement solutions.
Dalene Bartholomew CFE, CIFI
Vice President | VRC Investigations
Phone: 800-654-2185 option 7