CALIFORNIA — Two Irvine residents, Rebecca Juarez, 39, and Juan Pablo Rodriguez, 31, have been arrested and charged in a large-scale insurance fraud scheme involving the theft of patient identities and false medical billing.
The California Department of Insurance began investigating after several Orange County residents reported unauthorized medical charges appearing in their health insurance statements. These charges were for treatments and tests they never received.
Authorities allege that Juarez, who worked at a Mission Viejo medical office, accessed the clinic’s medical records system without permission. She reportedly stole the personal information of more than 21 patients and passed it on to Rodriguez.
Rodriguez, who had access to the billing system of a San Jose medical practice, allegedly used the stolen identities to create false records for procedures — including COVID-19 tests — that were never performed. Investigators say he then submitted these fake records to insurance companies, leading to fraudulent claims between August and November 2023. The scheme is believed to have attempted to defraud insurers of more than $10,000.
Both Juarez and Rodriguez were arraigned earlier this month in Orange County Superior Court. They face:
2 counts of conspiracy
21 counts of medical insurance fraud
21 counts of identity fraud
They were granted conditional release pending further court proceedings.
This case comes amid a broader national surge in insurance fraud involving identity theft. The National Insurance Crime Bureau (NICB) warns that these crimes could rise nearly 50% by the end of 2025. In 2024 alone, synthetic identity fraud contributed to over $47 billion in losses, according to AARP.
Experts say the growing use of artificial intelligence has made it easier for fraudsters to create fake but convincing identities. As a result, insurers are investing in machine learning and cross-industry collaboration to detect fraud earlier. Without effective prevention, analysts warn that rising fraud could lead to higher premiums for policyholders.
