On an unusual case that arose from a workers’ compensation lawyer’s office, a hearing representative from the law office was charged with multiple felony counts of insurance fraud and grand theft on November 12, 2015. There is no allegation that the lawyer knew of the alleged fraud. The case is being prosecuted by the Los Angeles County District Attorney's Office in Los Angeles County Superior Court.
Department of Insurance investigated hearing representative Ramon Humerto Otero of and an interpreter Efrain Heredia Ojeda. It is alleged that they conspired to steal an $18,946 settlement check intended for a client whose workers' compensation case Mr. Otero was presiding over and who passed away before the settlement with the insurer was achieved.
Mr. 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.
Mr. 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 Mr. Otero instructed the insurer to mail the settlement check to the residence of Mr. Ojeda, an interpreter and close associate of Mr. Otero. Mr. Ojeda allegedly forged the deceased's signature to endorse the settlement check and deposited it into his personal bank account.
Attorney Commentary: We have represented attorneys where their office staff were involved in illegal referral arrangements, improperly took funds from clients or engaged in other misconduct. Cases such as this can cause problems for attorneys with the State Bar or in a civil context.
Posted by Tracy Green, Attorney at Law