In a recent turn of events, the Orange County District Attorney’s Office has charged four men in connection with a significant workers’ compensation fraud scheme that allegedly generated nearly $10 million in illegal profits. The primary suspect, 55-year-old David Fisch from Laguna Niguel, is facing over a decade in prison due to his history of insurance fraud convictions, which have resulted in a lifetime ban from participating in California’s workers’ compensation system.
Following a three-year investigation, prosecutors revealed that Fisch secretly controlled clinics and medical service providers, utilizing illegal referral fees and falsely reporting charges to insurance companies to profit unlawfully. A statement from the Orange County District Attorney’s Office emphasized, “Fisch referred patients to specific providers to receive illegal referral fees and then billed workers’ compensation insurance companies for related services unlawfully.”
The other three defendants include 78-year-old Martin Brill, 61-year-old Robert Lee, and neurosurgeon Vrijesh Tantuwaya. According to the indictment, the defendants co-founded the Southern California Injury Network, offering medical management services that included marketing, billing, and collections. Although Fisch presented himself as a “consultant,” he was actually at the helm of the entire operation. Tantuwaya, who practices in San Diego and was also implicated, co-founded a medical group that served as a key partner for Fisch’s company. Tantuwaya’s attorney, Scott Simmons, firmly denied the allegations, highlighting the surgeon’s 22-year spotless professional record and asserting, “The evidence will prove his innocence; Tantuwaya has never received any illegal kickbacks.”
All four defendants have pleaded not guilty to the charges and have been released on bail while awaiting trial. Fisch is facing the most serious allegations, including two counts of conspiracy, two counts of soliciting compensation from clients, and eight counts of insurance fraud. Orange County District Attorney Todd Spitzer pointed out that such fraudulent actions not only inflate insurance premiums but also exacerbate the challenges faced by American families amidst rising living costs. Should the defendants be convicted, Fisch could face a sentence of over ten years.
The California Department of Insurance estimates that similar fraudulent activities cost state residents an additional $440 in premiums each year. The District Attorney’s Office underscored the importance of combating such fraud as a protective measure for all Californians.
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