Investigation Solutions Assists in $32 Million Employer Fraud Case

Sponsored Content By | June 21, 2017

San Diego, CA, June 21, 2017- Investigation Solutions, Inc. (ISI) worked alongside the California Department of Insurance in a $32 million workers’ compensation fraud case that resulted in an arrest earlier this month.

Detectives at the DOI arrested Gina Marie Gregori of Lafayette on charges of underreporting payroll and defrauding multiple carriers including a client of ISI’s to the tune of $32 million. Charged with 19 felony counts, Gregori is being held on $5.2 million bail at the San Francisco County Jail. Owner of three companies (GMG Janitorial, GMG Billing Services Plus and Apex Janitorial Solutions), Gregori allegedly underreported payroll and falsified documents to their workers’ compensation carrier.

“We see a lot of employer fraud in workers’ compensation,” said Tim Cloney, vice president of ISI. “Whether the employer is paying cash under the table, underreporting payroll or misclassifying employees, all in hopes of saving themselves some money, most of them leave a trail of some kind that is eventually uncovered.”

The carrier requested ISI’s help when they were alerted by the DOI of suspicions of fraud on the part of one of their insureds, Billing Services Plus, Inc. ISI Senior Investigator Marcella Graham ran a series of background checks into the three companies and their owners, and provided proof to the DOI that the three companies actually are one company.

Knowing that Billing Services Plus was due an audit because their policy was expiring, Mrs. Graham also alerted the auditor of the potential fraud. With the false documentation provided by the employer, the company’s payroll was shown to be only $259,000. The fraudulent data showed 10 full-time employees and 10 part-time employees, when the actual employee count was more than 200 with a possible $600 million in payroll; the exact dollar amount is still under investigation.

“By going the extra step in the investigation, Marcella provided key data to the DOI’s employer fraud task force,” Cloney explained. “In alerting the auditor to the possibility of fraud and working with the auditor to gather evidence, they helped strengthen the DOI’s case against the employer.”

Criminal charges were filed shortly after ISI handed information to DOI. The active criminal case is currently being prosecuted by the San Francisco County District Attorney’s Office.

About Investigation Solutions, Inc.
Investigation Solutions, Inc. is a multi-line claims investigation company providing nationwide field investigation, surveillance and SIU services to the insurance, legal and self-insured communities. For more information, please visit Investigation-Solutions.com.

Media Contact
Tim Cloney
760.827.4948
TCloney@investigation-solutions.com

Topics Fraud Commercial Lines Workers' Compensation Business Insurance

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