DATE: December 11, 2024
CASE: Gustavo Cisneros (Case #19FE017379)
PROSECUTOR: Deputy District Attorney John MacKenzie, Insurance Fraud Unit
Gustavo Cisneros pled no contest to felony insurance fraud. The Honorable Shauna Franklin sentenced Cisneros to 150 days county jail, 2 years formal probation and restitution in an amount to be determined to the victim.
In 2016, Cisneros reported he suffered multiple injuries from a fall while working as part of a construction crew. An investigation determined Cisneros exaggerated his claimed injuries and limitations. Cisneros was treated by multiple doctors, frequently changed providers and refused to cooperate with treatment plans. The treating physicians all stated that Cisneros' claimed injuries were inconsistent with the medical examinations, imaging studies and tests. A search of records determined that Cisneros had at least six previous workers' compensation claims. In these claims, Cisneros used different social security numbers and dates of birth to make his actions more difficult to detect. For many years after the reported incident, Cisneros claimed to multiple health providers that he had no pre-existing conditions and had never previously filed a workers' compensation claim.
Cisneros' fraudulent workers' compensation claim cost the employer and insurance company over $70,000. Workers' compensation fraud of this type not only has an immediate financial impact for the employer, but it also causes increases in premiums for employers in the longer term. Additionally, fraudulent claims clog up the system and delay medical care and financial assistance that legitimately injured workers need and deserve.
