Fake Robbery Followed by Stress Claim Leads to Fraud Conviction

A Sacramento woman has found big trouble with the California Restaurant Mutual Benefit Corporation (CRMBC) after their investigation lead to a conviction for Workers’ Comp fraud, which the self-insured group attributes to its “intensified campaign against Workers’ Compensation fraud.”

According to a Market Watch Press Release, the CRMBC announced that it now has a new conviction to add to its campaign against Workers’ Compensation fraud. Jeanette Gallo pleaded no contest in Fresno County Superior Court on August 31^st to one of two felony counts of insurance fraud.

Gallo, who was an assistant manager at a Jack in the Box restaurant in Fresno, filed a stress claim due to a robbery; even though, as it turns out, she played a part in that robbery.

The key to the conviction was the immediate action that was taken by the restaurants owners, Sanjiv Bhagat and Jyoti Madhura. They identified and started investigating several red flags that they observed.

Going against company policy, Gallo went in early in the morning to open the restaurant. Bhagat and Madhura also noted her unusual behavior on their surveillance tapes and interviews with employees, which added to their suspicions. Later on, due to their documentation and the close cooperation with City of Fresno detectives, an arrest was made with Gallo and her boyfriend getting a grand theft charge.

A later follow-up by third party administrators American Claims Management and their special investigations unit, Investigation Solutions, lead to the additional charges of insurance fraud.

“Fraudulent activity by a small fraction of providers and employees costs California employers many millions of dollars each year. Fraud in Workers’ Compensation brings real harm to the great majority, the honest employers, employees and doctors, and it costs jobs,” said David Mitchell, Chair of the CRMBC Board of Trustees.

Gallo’s sentencing is set for October 19^th.