Los Angeles, California Landscaper Arraigned for Alleged Employees’ Compensation Fraud of Over $50,000 in Incapacity Funds

Insurance ministry investigations lead to multiple charges of insurance fraud and perjury

Aug. 3, 2021 – LOS ANGELES – Frank Simplicio, 45, of Porter Ranch, has been charged with multiple charges of insurance fraud and perjury. An investigation by the Ministry of Insurance revealed Simplicio claimed he was too injured to work to collect over $ 50,000 in disability payments from an employer’s insurance company while illegally working for other employers.

On May 2, 2017, while working as a Green, Simplicio filed a claim with his employer’s insurance company, in which he pointed to cumulative trauma to the neck and back. He also claimed the job resulted in his diabetes, internal injuries, and trouble sleeping. He gave the dates of his accumulated trauma from July 19, 1996 to May 29, 2015. However, the lawsuit was filed two years after his alleged violations.

The investigation found that Simplicio received temporary total disability payments totaling $ 32,051 from February 20, 2018 through September 19, 2018. He also received permanent disability payments totaling $ 18,610 from September 20, 2018 through December 13, 2019.

In a statement, Simplicio said he was a landscaper but hadn’t worked since the day he was injured. However, surveillance recordings in October 2018 and February 2019 showed that Simplicio was actively working as a landscaper. A search warrant was later issued on Simplicio’s bank account records, which revealed that it collected checks from customers valued at over $ 450,000 from June 2015 to December 2019. This does not include possible income from direct deposits through his account.

When told what the investigation was, the qualified medical examiner who handled Simplicio’s claim said that Simplicio lied and that if they had known of his skills and employment, they would never have put him on a temporary total disability. Simplicio’s alleged actions resulted in his receiving $ 50,661 in undeserved disability payments. The total damage to the insurance company in this case was over $ 100,000, including unnecessary medical, investigation, and legal costs.

Simplicio surrendered before the Los Angeles Superior Courthouse and was charged on July 29, 2021. The Los Angeles District Attorney’s Office is pursuing this case.

Founded in 1868, the California Department of Insurance is the largest consumer protection agency in California. California insurers collect premiums of $ 340 billion annually. Since 2011, the California Department of Insurance has received more than 1,000,000 calls from consumers helping collect over $ 469 million in claims and premiums. Please visit the Ministry of Insurance website at www.insurance.ca.gov. Please direct inquiries outside the media to the consumer hotline at 800-927-4357. Teletype (TTY), please dial 800-482-4833.
Source: CA. Insurance department