Charges filed in massive workers compensation insurance referral scheme
Ten attorneys and six cappers were charged for participating in a massive multi-million dollar workers’ compensation insurance referral scheme that exploited persons in predominantly Spanish-speaking communities. This is the first phase of filing resulting from a 3-year insurance fraud investigation by the Orange County District Attorney’s Office (OCDA) Bureau of Investigation, Insurance Fraud Unit with assistance from the California Department of Insurance (CDI).
The defendants were charged on June 5, 2017, with multiple felony counts of:
- Conspiring to refer clients for compensation
- Referring patients/ clients with reckless disregard for commission of fraud
- Insurance fraud
Sentencing enhancements were added for aggravated white collar crime over $500,000 and a loss over $1.3 million.
The ten attorneys charged in the case are:
- Jon Woods, 56, Cypress, State Bar #181388
- Payman Zargari, 49, Sherman Oaks, State Bar #208451
- John Jansen, 49, Santa Ana, State Bar #182405
- Fari Rezai, 39, Irvine, State Bar #195149
- Lionel Eduardo Giron, 49, Pomona, State Bar #200450
- Dennis Ralph Fusi, 73, Lakewood, State Bar #70905
- Jorge Humberto Reyes, 39, Los Angeles, State Bar #232350
- Rony M Barsoum, 43, Los Angeles, State Bar #231843
- Robert Irving Slater, 67, Encino, State Bar #67572
- Robin Jacobs, 52, Sherman Oaks, State Bar: #167089
They face a maximum sentences range from seven years to 25 years and eight months in state prison.
Six cappers were also charged in the case:
- Carlos Arguello III, 35, Tustin
- Maximum sentence: 29 years and eight months in state prison
- Edgar Gonzalez, 50, Anaheim
- Maximum sentence: 20 years and eight months in state prison
- Boris Mikhayovich Dadiomov, 31, San Diego
- Soraida Veronica Castro, 42, Imperial Beach
- Tania Arguello-Plasencia, 31, Tustin
- Dulce Gallegos, 30, San Ysidro
Individual complaints specifying charges for each defendant are available upon request.
Circumstances of the Case
In 2005, Carlos Arguello III is accused of forming Centro Legal Internacional, an “advertising” company, and securing unlawful referral contracts with 20 to 40 workers’ compensation insurance and personal injury attorneys. Arguello is accused of requiring all participating attorneys to sign annual contracts for his “joint advertising program.”
Defendant Arguello is further accused of creating contracts that specified a monthly fee and named the marketing service provider as Centro Legal Int’l, Justicia Legal Int’l, or Centro de Abogados Int’l, which were owned by Arguello and operated by his associates.
Arguello is accused of requiring the attorneys to use several other companies owned or controlled by Arguello and Edgar Gonzalez, including: USA Photocopy, C & E Technology, Professional Document Management, and Providence Scheduling.
Defendants Tania Arguello Plasencia, Boris Mikhayovich Dadiomov, Soraida Veronica Castro, and Dulce Gallegos (Cappers) are accused of working and capping for Arguello.
Arguello and Gonzalez are accused of being the masterminds behind the unlawful referral network.
How the Referral “Mill” Worked
The defendant attorneys in this case are accused of paying a monthly fee for the Cappers to procure and deliver an agreed upon minimum number of retained clients per month.
Cappers are accused of distributing flyers and business cards in predominantly Hispanic neighborhoods, businesses, swap meets, and the U.S.- Mexico border. Cappers are further accused of publishing advertisements in Spanish-language publications and using misleading websites offering legal services, including iwantmylawyernow.com, instantlawyeraccess.com, centrodeabogadosinternacional.com, uniondeabogadoslatinos.com, and unitedinjuryattorneys.com.
Each website and advertisement offered a “free consultation” via an online consultation form or a toll-free number. The toll-free numbers for Centro Legal Int’l, Justicia Legal Int’l, and Centro de Abogados were all directed to a call center in El Salvador.
Once a caller showed interest in signing up, Cappers are accused of dispatching a recruiter, who acted as an agent from the subscribing law firm, to the caller’s home within 24 to 48 hours to obtain the applicants’ signatures on an intake packet, numerous blank documents, and an attorney retainer agreement, without any contact with or input from the assigned attorney.
Cappers are further accused of forwarding the completed intake packet to participating attorneys and medical providers within the referral network.
In addition to paying monthly “marketing” fees, the attorneys involved in the scheme are accused of using copy services owned or controlled by Cappers and authorizing staff from various copy companies run by the cappers to inspect the attorneys’ client files for information to prepare copy service orders for subpoenaing records.
The attorneys are accused of permitting Cappers to order, prepare, and submit documents on behalf of the attorney without attorney oversight or approval in violation of law.
On the medical provider side, individual medical providers are under investigation for paying for patients recruited by the Cappers, and then prescribing durable medical equipment and pharmaceutical goods through vendors, and referring diagnostic imaging requests to companies chosen by the Cappers.
In 2014, the OCDA received a tip from a major insurance carrier and initiated an investigation in conjunction with CDI, which led to the investigation into the unlawful referral scheme.
As there will be other phases, the OCDA and CDI will not be providing further details at this time.
Laws Against Receiving Compensation for Referrals
Business & Professions Code ง 6152 prohibits individuals or businesses from procuring clients (aka “capping”) for attorneys or law offices. Likewise, Insurance Code ง 750 and Labor Code ง 3215 also prohibit attorneys from paying cappers for referred clients. Insurance Code ง 750 and Labor Code ง 3215 also prohibit copy service companies from offering any type of consideration to attorneys in exchange for the referral of business. Moreover, conspiring to illegally refer or pay for clients and hiding the capping from the insurance company in order to obtain benefits is further prohibited by Penal Code งง 549, 550(a)(1), and 550(b)(3).
The Orange County District Attorney’s Office Bureau of Investigation investigated this case with the assistance of the California Department of Insurance.
This case is being prosecuted by Deputy District Attorney Noor Hasan, Insurance Fraud Unit.
This article was released by the Orange County District Attorney’s Office.
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