California Medical Insurance Fraud Scheme Uncovered Involving Patient Identity Theft

In Irvine, California, two individuals, Rebecca Juarez and Juan Pablo Rodriguez, were arrested on multiple charges related to an insurance fraud scheme involving stolen patient identities and false insurance claims. The California Department of Insurance initiated the investigation after Orange County residents reported unauthorized charges on their health insurance explanation of benefits statements.

Juarez allegedly accessed a medical practice's computerized records system to steal personal information of more than 21 patients, which was then shared with Rodriguez. Rodriguez used this information to create fraudulent medical records for tests, including COVID-19 tests that were never conducted, and submitted these false claims through a medical practice's insurance billing system in San Jose.

The fraudulent charges were submitted to various medical insurers between August and November 2023, with an estimated intended loss exceeding $10,000. Both individuals were arraigned and are scheduled to return to court on December 3, 2025. This case is being prosecuted by the Orange County District Attorney's Office. The California Department of Insurance, under Commissioner Ricardo Lara, continues its efforts to protect consumers by regulating the insurance industry, overseeing insurer solvency, investigating fraud, and ensuring fair insurance practices across California, the nation's largest insurance marketplace.