A West Sacramento woman has pleaded guilty to wire fraud in a case that involved filing false workers’ compensation claims for a former National Football League player. Kimberly Jones, 40, entered the plea and agreed to submit to a restitution order of at least $1.5 million, according to a U.S. Attorney’s Office news release.
Court documents indicate that from September 2001 through August 2011, Jones was employed as a senior claims representative, or claims adjuster for a third-party administrator that managed, among other things, workers’ compensation claims in California on behalf of Pennsylvania Manufacturers’ Association Insurance Group, or PMA.
Jones’ co-defendant, Marcus Buckley, 42, of Weatherford, Texas, played professional football in the National Football League between 1993 and 1999 with the New York Giants. During this time, 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 allegedly 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 checks made payable to Buckley. In total, Buckley received more than $1,588,000 to which he was not entitled.
Charges against Buckley are pending. Jones it to be sentenced January 7 2016 and 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. 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.