On August 10th, 2021

Two Suspects Arraigned in Health Care Fraud Case A California Department of Insurance investigation

“The amount of insurance fraud in California and this country is staggering.  Insurance fraud ends up costing all of us money in higher premiums.  Fortunately, California Department of Insurance investigators are a dedicated group and very good at identifying and investigating those committing such fraud.” – CSLEA President Alan Barcelona

BONITA— Jacob Hasum Smith, 39, of Bonita, and Charity Lynn Moulder, 61, of Rural Retreat, Virginia, have been charged with 36 felony counts of insurance fraud and grand theft for allegedly collecting long-term health care benefits as a result of fraudulent claims.

According to a California Department of Insurance (CDI) investigation, after receiving injuries as a result of an automobile collision, Moulder filed a claim with her insurance company under a long-term health care policy, requesting a paid caregiver to assist her during recovery. Moulder originally requested a family member be paid as her caregiver, which was denied. Moulder named another caregiver, Jacob Smith, her daughter’s then boyfriend, and the claim was approved.

Moulder and Smith submitted 38 separate documents reflecting Smith’s reported care of Moulder over a 16-month period of time. The pair claimed Smith cared for Moulder every day, seven days a week, sometimes up to 14 hours a day without a break in service and assisted with bathing, washing, physical assistance, feeding and cleanup along with other tasks.

The CDI investigation revealed that during this same time period, Smith worked and traveled throughout San Diego County and elsewhere in California and Nevada while he reported being with Moulder and providing for her needs, making it impossible for Smith to have cared for Moulder as the claims stated.

Moulder later admitted to detectives that Smith only cared for her part of the time she was collecting benefits but she continued to pay him. She also paid another relative who provided care despite being told by her insurance company that was against policy.

Moulder and Smith were arraigned on August 3, 2021. Smith has an outstanding warrant for unrelated charges and is a fugitive at this time.

The San Diego County District Attorney’s Office is prosecuting this case.

 

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