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May 15, 2019
California Division of Workers’ Compensation Validation of Uniform Assigned Name Required When Filing Documents in EAMS
May 8, 2019
Doctor, Psychologist Charged With Fraudulent Workers’ Compensation Evaluations In Central Valley. Task Force Uncovers Attempted Theft Of Tens Of Thousands Of Dollars Of Fraudulent Bills To Insurance Companies.
May 5, 2019
15 Chiropractors Are Charged in a Six Million Dollar Auto Insurance Fraud and Kickback Scheme
May 2, 2019
Carlos Arguello Sentenced To Four Years In California State Prison. Jon Woods To Face New Trial In Orange County.
|Pasadena Insurance Broker Allegedly Commits Identity Theft For Unearned Commissions|
By Lonce Lamonte and the California Department of Insurance - May 6, 2019
Helen Lee, a 39-year-old licensed insurance broker, has been charged with nine felony counts of identity theft after allegedly using others’ personal health information to forge fraudulent agent of records forms in the hopes of receiving unearned commissions.
“When this licensed broker allegedly used Craigslist to obtain personal health information in a scheme to line her pockets, the department stopped her,” said Insurance Commissioner Ricardo Lara. “My department is committed to protecting Californians’ privacy against insurance crime.”
Lee, co-owner of Joany Inc. and California Health Benefit Exchange, which were billed as health concierge services companies, filed more than 65 agent-of-record change forms in order to claim broker status with members already enrolled in a health plan between January 2017 and March 2017.
Lee allegedly created an online Craigslist survey, marketed as an Online Health Insurance Research Study, to obtain personal identifying information. Lee paid participants $50 if they met certain criteria and texted a photo of their member ID card which included effective dates of coverage.
The survey had a HIPPA compliant logo and participants were told it was only to help consumers with their health insurance needs and that the information would not be sold or provided to any third party. However, participants’ information was used to change their agent of record and their signatures were forged on the documents. The survey specifically targeted consumers who purchased insurance through Covered California provided they did not receive health care through their employer and were not part of Medicaid, Medicare or VA health insurance.
Lee’s illicit activities stretched nationwide. CDI is assisting other affected states’ insurance departments in their investigations. If anyone has information on these investigations, we urge them to call the department at 323-278-5000.
Lee’s license is being reviewed by CDI’s Legal Division for appropriate action. The case is being prosecuted by the Los Angeles County District Attorney’s Office.