July 9, 2014
OLYMPIA, Wash. – A jury convicted Andre R. Zamora, 25, of Tacoma of insurance fraud today in King County Superior Court after attempting to bilk an insurance company of more than $13,236 by altering medical bills. Zamora will be sentenced on July 25.
Zamora was charged with one count of felony insurance fraud in October 2012 after an investigation by Insurance Commissioner Mike Kreidler’s Special Investigations Unit (SIU).
In November 2011, Zamora was involved in a car collision in Tacoma when another driver turned in front of him. After the collision, Zamora sought medical attention at a Renton hospital emergency room and later sought a second opinion from a Bellevue hospital. Zamora then submitted the medical bills to USAA, the other driver’s insurance company, saying he had paid the bills and wanted reimbursement. He submitted three claims to USAA totaling more than $14,857; the actual amount of the three claims totaled $1,621.
“Insurance fraud is not a victimless crime, despite what criminals may think,” said Kreidler. “I appreciate the work of the insurance company investigators, my investigators and the King County Prosecuting Attorney’s Office on this case.”
The insurance company paid Zamora's first two claims, netting him $4,200 more than the actual cost of the bills. He submitted a third claim that was inflated by $9,000; the company sought documentation, which Zamora refused to provide. He also refused to provide authorization for the company to contact the hospital directly for a copy of the bill. The insurance company declined the bill and referred the case to Kreidler’s office. Zamora failed to appear for his original trial date in February 2014.
Kreidler’s Special Investigations Unit investigates insurance fraud and works with the Attorney General’s Office or local law enforcement—in this case, King County – to prosecute criminal cases. In 2013, the unit prevented more than $237,000 in losses in Washington state. Consumers can report suspected insurance fraud on the Insurance Commissioner’s website.