Attorney General Scott Pruitt’s Workers’ Compensation and Insurance Fraud Unit Friday filed eight felony charges against an Oklahoma City insurance agent for making false or misleading statements in insurance applications and obtaining money by false pretenses.
According to the charges filed in Oklahoma County District Court, Fernando Espinoza, 27, of Norman, allegedly miscoded workers' compensation insurance policy applications so that roofing companies would appear as "paint and paper hanging" companies in order to obtain workers' compensation insurance. The insurance company doesn’t issue workers’ compensation policies to roofing companies and therefore, considers these policies to be invalid.
In interviews with investigators, the roofing companies stated they told Espinoza they were primarily roofing companies. According to the charges, there were several cases where he would issue certificates of insurance that were not backed by actual policies and would use a quote number instead of a policy number. While appearing genuine, there were no actual policies.
The case was referred to the AG’s Office by CompSource Oklahoma, which provides workers’ compensation insurance to employers in the state. It came to their attention through audits of the general contractors of the roofing companies who had been given the false insurance policies.
“Every fraud case results in higher costs and reduced efficiency within our state’s workers’ compensation system,” Pruitt said. “We must remain diligent in investigating and prosecuting those who attempt to cheat and take advantage of the system.”
If convicted, Espinoza could face up to seven years in jail and/or a fine up to $10,000.
The Attorney General’s Workers’ Compensation and Insurance Fraud Unit is the only Oklahoma law enforcement agency dedicated to the investigation and prosecution of workers’ compensation fraud. The Unit also helps raise public awareness of fraud in Oklahoma.
To report workers’ compensation or insurance fraud, contact the AG’s Workers’ Compensation and Insurance Fraud Unit at (405) 521-3921.
For a copy of the charges, go online to www.oag.ok.gov.