Defendant in $670M scam enters guilty plea in Va.

Headline Legal News

A man who cooked the books for a $670 million insurance industry scam pleaded guilty Monday to charges he helped mislead thousands of investors worldwide.

Jorge Luis Castillo, 56, Hackettstown, N.J., entered pleas in U.S. District Court to conspiring to commit mail and wire fraud in U.S. District Court. He is scheduled for sentencing May 22 and could receive up to 20 years in prison and fined up to $250,000.

Castillo, who originally was scheduled for trial in 2012, will assist the government's prosecution of Minor Vargas Calvo, 60, the president and majority owner of Provident Capital Indemnity Ltd., a Costa Rican company. He is scheduled for trial in February. He has pleaded not guilty to similar charges.

The government called Castillo a "gatekeeper" for Provident. As a certified public accountant, he cast himself as an "outside auditor" and falsely reported a rosy financial picture for the company, which had a global client base.

"This is truly an international fraud in scope," U.S. Attorney Neil H. MacBride said in a conference call after Castillo entered his plea. "As a result of Mr. Castillo's crimes, a lot of people lost life savings to life settlement companies because of the worthless guarantees that Mr. Castillo helped create.

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Workers’ Compensation Subrogation of Administrative Fees and Costs

When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.

In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.

In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.

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