An insurance agent is accused of taking money for workers' compensation policies even though he knew his company wouldn't provide certificates.
An Oklahoma City insurance agent regularly accepted thousands of dollars from roofing companies for workers' compensation insurance, even though he knew his company would not issue the policies, according to charges filed in Oklahoma County District Court.
Fernando Espinoza, 27, would miscode the type of business in his communication with Farmers Insurance to indicate the companies performed painting, paper hanging, general carpentry and fence installation instead of roofing, according to court documents.
He then provided fraudulent certificates of insurance for workers' compensation to the roofers, according to court documents. In one case, he provided a certificate for general liability insurance.
The incidents occurred from Dec. 10, 2010 to Feb. 29, 2012. Eight felony counts were filed against Espinoza on April 5, 2013.
Espinoza admitted to an investigator with the Workers' Compensation and Insurance Fraud Unit of the state Office of the Attorney General that "he bent the rules to issue Commercial Certificates of Insurance by using quote numbers so the [insureds] could work, while waiting on underwriters to make a decision."
"Espinoza admitted that he would code policies for work other than roofing due to the fact Farmers Insurance Exchange does not insure any type of roofing work," the documents said.
The case was referred to the state attorney general's office after field auditors from CompSource Oklahoma, a nonprofit insurance company that provides workers' compensation, saw the certificates at various worksites and learned they were fraudulent after contacting Farmers.
In some instances, the certificates were issued based on a miscoded business type. In other instances, a quote number was used in the place of a policy number, according to court documents.
If convicted, Espinoza faces up to seven years in prison and a $10,000 fine for seven counts of workers' compensation fraud, in addition to up to one year in prison and a $5,000 fine on one count of obtaining money or property by false pretenses.
By Anne Freedman
June 1, 2013
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