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adjustercom.net - FraudFromInsideAndOutsideTheCourtroom

 


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Injured Worker's Hearing Representative And Co-Conspirator Caught Cashing Settlement Check
By California Department Of Insurance - November 13, 2015

LOS ANGELES, Calif. - Department of Insurance detectives arrested Ramon Humberto Otero, 37, of Adelanto, and Efrain Heredia Ojeda, 43, of Corona, last week on multiple felony counts of insurance fraud and grand theft. The duo allegedly conspired to steal an $18,946 settlement check intended for a client whose workers' compensation case Otero was presiding over and who passed away before the settlement with the insurer was achieved.
 
Otero, a hearing representative for the law offices of Ramon Otero Jr., negotiated a workers' compensation settlement agreement for his client. During the course of the negotiation, his client passed away. Otero still proceeded with negotiations despite the passing of his client and reported to the insurer that his client's address changed. Suspecting fraud, the State Compensation Insurance Fund referred the claim to the Department of Insurance for investigation. Detectives found evidence that Otero instructed the insurer to mail the settlement check to the residence of Ojeda, an interpreter and close associate of Otero. Ojeda allegedly forged the deceased's signature to endorse the settlement check and deposited it into his personal bank account.
 

Ramon Umberto Utero, booking photo
 
"Insurance fraud is not a victimless crime," said Insurance Commissioner Dave Jones. "These types of crimes negatively impact consumers, insurers and California's economy."
 

Efrain Heredia Ojeda, booking photo 
 
Otero was booked into the Inmate Reception Center in Los Angeles. Ojeda was booked into the Robert Presley Detention Center in Riverside. Both face a maximum five-year prison sentence if convicted on all counts. This case is being prosecuted by the Los Angeles County District Attorney's Office.
 
from the California Department of Insurance News Release
 
 

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