San Jose gas station owner charged with insurance fraud

SAN JOSE (BCN) — The Santa Clara County District Attorney’s Office has charged a
lab worker, store housekeeper and a roofer with felony insurance fraud,
alleging they falsely claimed that employment injuries kept them from going
back to work, a prosecutor said Wednesday.
The three people, who collected thousands of dollars in workers’
compensation insurance benefits that prosecutors said they did not deserve,
were arraigned over the past two weeks and are out of jail pending their
preliminary hearings, Deputy District Attorney David Soares said.
Cosme Cortes-Alva, 39, and Nancy Benitez, 28, both of San Jose,
and Ajitender Singh Chadha, 53, of Union City, if convicted of insurance
fraud face serving prison time and will be ordered to repay the compensation
insurance companies provided them, Soares said.
The Insurance Fraud Unit of the District Attorney’s Office reviews
hundreds of workers’ compensation fraud cases within the county each year and
is seeking to get the word out about these recent cases, he said.
“We want to show a light to the public that overstating claims
have criminal consequences,” he said.
Alva, Benitez and Chadha each claimed to have suffered
debilitating injuries on the job and filed claims with their employer’s
workers’ compensation insurance policies, which employers are required to
provide under state law, he said.
The payments are meant to help cover housing and other living
expenses for injured workers during a period of rehabilitation before they
may return to work, according to Soares.
However, in-house company investigators or hired private
investigators observed Alva, Benitez and Chadha performing duties beyond what
they stated their limitations were while still cashing checks for thousands
from the insurance companies, he said.
Alva, a roofer who reported falling off a roof and badly injuring
his back in 2013, was seen on a videotape working on a roof for two hours
while walking up and down a ladder after claiming he was too hurt to work and
terrified of ladders, Valley Fair
He also falsely testified in a deposition that he had not worked
since he was injured, according to prosecutors.
Benitez, injured while employed as a housekeeper for a store at
the Westfield Valley Fair mall in San Jose in 2011, was seen driving to a
mall, shopping and caring for a small child after telling her insurance
company she could not walk or drive without extreme pain, they said.
Chadha, hurt in an accident at a laboratory in 2011, claimed he
could not work and was living off his wife’s income but investigators learned
he owned and operated a gas station and was concealing his income, according
to prosecutors.
Soares said that the vast majority of people living on monthly
workers’ compensation payments, which are based on a percentage of their
previous wages, are not committing fraud.
People on workers’ compensation normally make regular visits to
doctors who examine them while they are being rehabilitated and see if they
may be rated as ready to resume their jobs, he said.
In Benitez’s case, a doctor had cleared her to return to work, he
said.

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