On February 15th, 2019

Three Medical Office Employees Arrested for Insurance Fraud Suspects allegedly attempted to scam more than $4 million from insurer

Isabel Guizar, Susie Quezada, and Erika Lopez

DIAMOND BAR  — On February 13, 2019, three medical office employees were arrested for allegedly filing more than $4 million in false insurance claims for treatments they claimed they received from their employer at Diamond Bar ENT Medical Specialty Group. The victim-insurer paid out more than $540,000 as a result of the fraudulent claims.

According to the California Department of Insurance, Isabel Guizar, 45, Susie Quezada, 50, and Erika Lopez, 40, allegedly submitted false claims to the insurance company for treatments that included nasal surgeries, laryngoscopy biopsies, impaction removals, swallowing dysfunction, nystagmus tests, nasal injections and therapeutic vocal cord injections. It is alleged that the employees provided the insurance company with handwritten receipts and altered claim forms and were reimbursed directly for the treatments, money in which they allegedly pocketed.

“California Department of Insurance investigators have proven they are very thorough in their investigations which result in successful prosecutions of those who commit insurance fraud,” said California Statewide Law Enforcement Association (CSLEA) President Alan Barcelona. “The crimes these three are accused of impact all of us as they result in higher health care premiums.”

One of the suspects, Quezada, has also been charged for embezzling approximately $700,000 from Diamond Bar ENT Medical Specialty Group and filing a false tax return.

 

 

 

 

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