In 2003 the account was opened with the name WC Surgery Centers or WCSC according to the Fictitious Business Name Statement filed.  But in 2005, the name changed to WCSC & Associates.  Keisha Woods followed up to the name change and requested additional information for tax ID or partnership.  She did not receive a reply and followed up.  On July 26, 2007 she documented in her file, “Have not received information as requested.”

Keisha Woods went through documents of copies of some of more than 50 checks that were deposited between 2004 and 2006.  She was questioned by the DA as she reviewed copies of the fronts and backs of checks for many different amounts.  Some of the amounts were: $4,949.00 8/30/2004, $67,941 11/15/2004, $15,850.61 1/31/2005, $14,153.33 2/28/2005.   This questioning of the witness to verify the amounts and documentations on the fronts and the backs of checks was very tedious and infinitely boring.  Finally the defense stipulated to their authenticity and the proceedings moved on.

The next witness for the prosecution was Sylvia Zamora, the Administrative Manager of Human Resources for AIG in Santa Ana.  Sylvia testified that Hector Porrata and George Martinez started working at AIG in Santa Ana as temporary adjusters in 2005 through a temp agency called ATI Claims Services.  Hector’s supervisor was Linda White. 

Next, Linda White came to the stand.  She looked attractive with her slim framed eye glasses and brown hair with light streaks.  Her testimony lasted through the next day, January 6, 2010.  It came out in her testimony that Hector Porrata was always a temporary adjuster, therefore, he always had only $5,000 in payment authority.  George Martinez started as a temp but later went permanent as a Claims Adjuster II, so he as a Claims Adjuster II got $50,000 of payment authority.  Cara Cruz-Thompson started as a temp, too, also in 2005, but then she became a regular Claims Adjuster II also with $50,000 of payment authority like George Martinez.

The DA, Tom Schultz, questioned Linda White about how the claims department worked, and how demand letters, for example, were received.

Linda White:  You could receive anything through the mail or fax machine.  As of 2005, all mail went to Olathe, Kansas, and would be scanned and then go to the adjuster’s work list.  Faxes would go to their individual fax. 

What Linda testified was peculiar and not normal was that sometimes the payments to WCSC for liens were often authorized and then released before the demand letters were even received.  One demand letter from WCSC stating they represented St. John’s Hospital, was sent to the P.O. Box on November 14, 2005, so it got to Olathe, Kansas for scanning on November 17, 2005.  Linda knew this letter went to the P.O. Box because there was no fax number on the top of the page.  But Hector Porrata authorized it on November 16, 2005 a day before he even received the demand letter.  

This lien was for $68,000 and it was paid to WCSC.  The way Porrata got the payments released, since he only had $5,000 payment authority as a temp, was that he would send them to any adjuster in the office with payment authority at that level and ask the adjuster to release the payment.  This is a normal practice.  According to Linda White’s further testimony, any manager can review and release the payment, or another adjuster with the payment authority can approve it and release it.  Linda approved one payment on another file and occasion, but changed the amount.

Then, six months later a check for $7,000 was paid from WCSC to the true lien holder.  The true lien holder was the collection agency Grant & Weber who truly represented St John’s Hospital.  The WCSC check was documented referencing Sheila Dowden as the claimant from GTE-Verizon who had been treated at St. John’s Hospital.  But 100% of their lien was paid to WCSC for $68,000.  But, only $7,000 was paid to Grant & Weber the true representative, making a difference of $61,000.  

Tom Schultz, the DA, asked Ms. White how she knew who made the payments.

Linda White:  How we know who made those payments?  Line items.  It shows Hector Porrata’s adjuster #M165, One Macarthur Place.  Log-in ID.  What they use to sign on to the main frame.  An adjuster is assigned an adjuster number at the time of hire.

Many other demand letters came in, and payments were authorized on the same day as the demand letter was received. 

Tom Schultz:  Is this usual and customary?

Linda White:  Very unusual. 

Tom Schultz: Were you approached for possible theft?

Linda White: Two individuals from New York showed up: John Driscoll and Jane Gerasimola.  They asked, “Do we have an outside company that negotiates our liens?”

Tom Schultz: Did you talk about transactions or individuals?

Linda White: They had a large list of names.  They were asking me who they were, what their capacity was.

Linda White emphasized that liens are not a top priority for adjusters. On another case with Pacific Hospital of Long Beach, a global settlement was made in 2004. But a demand letter came in from WCSC after the global settlement.   The demand included an anesthesia specialist plus Pacific Hospital, so multiple checks should have been issued.  But on December 13, 2005 the demand letter was faxed and it was authorized by Porrata that same day. The adjuster who released the payment was George Martinez. 

Readers may write to writer Lonce LaMon at lonce@adjustercom.com.