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| | Workers' Compensation Claims Adjuster Kimberly Jones To Be Sentenced On January 7th 2016 For Fraud
By Lonce LaMon - October 13, 2015
A workers' compensation claims adjuster has pled guilty to wire fraud in a case that involved filing false workers’ compensation claims for a former National Football League player.
Court documents indicate that from September 2001 through August 2011, Jones was employed as a senior claims adjuster at Gallagher Bassett in Sacramento, California. Gallagher Bassett was the third-party administrator handling the workers’ compensation claims in California for Pennsylvania Manufacturers’ Association Insurance Group, or PMA.
Jones’ co-defendant, Marcus Buckley, 42, of Weatherford, Texas, played professional football in the National Football League between 1993 and 1999 with the New York Giants. During this time, the Giants had workers’ compensation insurance coverage through PMA.
Marcus Buckley, right, was a draft pick for the New York Giants in 1993.
In 2006, Buckley filed a workers’ compensation claim against the Giants for cumulative stress injuries sustained while playing football, in part, in California. In November 2010, the claim was settled for $300,000.
But after his claim had been settled, between 2010 and June 2011, Buckley allegedly prepared and filed numerous additional requests for reimbursement against the closed claim. He allegedly prepared fictitious invoices and statements from medical providers for medical services purportedly provided to him and fictitious credit bills. Buckley allegedly sent the fictitious invoices, statements and credit collection letters to Jones, who had Gallagher Bassett checks made payable to Buckley. As a result, Buckley allegedly received more than $1,588,000 to which he was not entitled.
Charges against Buckley are pending.
Kimberly Jones will be sentenced Jan. 7th 2016 by U.S. District Judge Troy L. Nunley. She faces up to a maximum sentence of 20 years in prison and a fine of a quarter million dollars or twice the gross gain or loss.
lonce@adjustercom.com; Lonce LaMon, journalist
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