Surveillance Footage Results in Prices In opposition to Madera Lady for Employees’ Compensation Fraud, California Division of Insurance coverage Studies

March 14, 2021 – FRESNO, California – Veronica Catalina Cortes-Ambrosio, 53, of Madera, was allegedly charged with two insurance fraud offenses Lying about physical limitations due to an injury at work in order to receive undeserved employee compensation.

An investigation by the Ministry of Insurance on May 6, 2017 revealed that Cortes-Ambrosio was working for an agricultural work company when she was hit with a garden tool by an employee, resulting in injuries to her right shoulder, neck and back. She was examined and received initial treatment for the alleged injuries, but the workers’ compensation claim she submitted was denied.

Cortes-Ambrosio continued to seek medical help and obtained legal counsel to pursue the claim. She claimed to have severe and almost constant pain associated with the injury and was unable to perform everyday activities such as sitting, standing, walking, reaching, and lifting. Cortes-Ambrosio’s employer offered her changed duties due to her stated restrictions, but refused and did not return to work.

Cortes-Ambrosio was video-monitored while she was claiming physical limitations due to the injury. The video showed her cleaning in and around her house, gardening, climbing and descending stairs, reaching her head, and lifting – all tasks that she allegedly could not do and that prevented her from returning to work .

Cortes-Ambrosio’s fraudulent claims of persistent pain and the inability to perform basic work functions resulted in her employer’s insurance company paying approximately $ 48,140 in unnecessary medical, investigative, and legal costs.

Cortes-Ambrosio will be charged on May 26, 2021. This case is being prosecuted by the Fresno District Attorney’s Office.
Source: CA. Insurance department