Sacramento, CA – Kimberly Jones, 50, of West Sacramento recently pleaded guilty to wire fraud and agreed to submit to a restitution order of at least $1.5 million, United States Attorney Benjamin B. Wagner announced.
According to court documents, from September 2001 through August 2011, Jones was employed as a Senior Claims Representative, or claims adjuster, at Gallagher Bassett Services Inc. in its Sacramento office. Gallagher Bassett was a third-party administrator that managed, among other things, workers’ compensation claims in California on behalf of Pennsylvania Manufacturers’ Association Insurance Group (PMA). Co-defendant Marcus Buckley, 42, of Weatherford, Texas, played professional football in the National Football League between 1993 and 2000 for seven seasons with the New York Giants. During this time period, the Giants had workers’ compensation insurance coverage through PMA.
In 2006, Buckley filed a worker’s compensation claim against the Giants for cumulative stress injuries sustained while playing football, in part, in California. In November 2010, the claim was settled for $300,000.
After his claims had been settled, however, between late 2010 and June 2011, Buckley prepared and filed numerous additional requests for reimbursement under his closed claim. He prepared fictitious invoices and statements from medical providers for medical services purportedly provided to him and fictitious credit collection notices from collection agencies purportedly seeking payment from Buckley for past due medical bills. Buckley sent the fictitious invoices, statements, and credit collection letters to Jones who had Gallagher Bassett checks made payable to Buckley. In total, Buckley received more than $1,588,000 to which he was not entitled.
This case is the product of an investigation by the Federal Bureau of Investigation. Assistant United States Attorney Michael M. Beckwith is prosecuting the case.
Jones is scheduled to be sentenced on January 7, 2016, by United States District Judge Troy L. Nunley. Jones faces a maximum sentence of 20 years in prison, a fine of $250,000 or twice the gross gain or loss in the case, and a three-year term of supervised release. The actual sentence will be determined at the discretion of the court after consideration of any applicable statutory sentencing factors and the Federal Sentencing Guidelines, which take into account a number of variables.
Charges against Buckley are pending. The charges are only allegations; he is presumed innocent until and unless proven guilty beyond a reasonable doubt.
Source: US Attorney’s Office