Conviction for Health Insurance Fraud Upheld

3 days ago
43

Physician Conspired with Bonavilla to Effect Health Insurance Fraud
Post 5212

Dennis Davin Bonavilla was involved in an insurance fraud scheme as an executive of Free Choice Healthcare. The scheme targeted indigent patients, often on government-assisted insurance (Medi-Cal/Medicaid), convincing them to switch to group insurance policies obtained by Free Choice. Patients were falsely represented as employees of sham companies (Drexel Group, Kingmakers) to qualify for these policies.

In The People v. Dennis Davin Bonavilla, 081765, California Court of Appeals, Fourth District, Second Division (October 9, 2025) people identified as patients of Bonavilla and Free Choice Healthcare's patients signed documents (often without understanding them) making them “employees” of Bonavilla's companies. Payroll services issued fake paychecks to patients, which were actually deposited into company accounts by a co-conspirator with power of attorney.

Dr. Iqbal

Dr. Iqbal, a pain management doctor, agreed to pay Free Choice 30–35% of the insurance claims he collected for procedures performed on these patients. Insurance companies would not have issued policies had they known the true facts (patients not employees, illegal waivers of copays/deductibles, kickbacks).

Financial Transactions:

Dr. Iqbal paid Bonavilla and Free Choice via large checks (totaling over $442,000), representing the agreed kickbacks. These transactions formed the basis for the money laundering charges.

Patient Experience:

Patients did not receive actual employment or paychecks. Treatments did not change after switching insurance; the main difference was billing location and insurance coverage.

LEGAL ISSUES & HOLDINGS
Standard of Review

The appellate court applies a deferential standard: it reviews the record in the light most favorable to the judgment, asking if any rational trier of fact could have found the defendant guilty beyond a reasonable doubt.

Aiding and Abetting Insurance Fraud

The elements of the crime of fraud requires a knowing presentation of a false claim for health benefits and specific intent to defraud. Substantial evidence showed Bonavilla aided and abetted Dr. Iqbal in submitting fraudulent claims by misrepresenting patient employment status.

Solicitation to Commit Insurance Fraud

The elements of the crime of solicitation to commit insurance fraud requires knowingly or recklessly soliciting, accepting, or referring a client intending to file a fraudulent claim.

Conspiracy to Commit Insurance Fraud

The elements of the crime of Conspiracy to Commit Insurance Fraud requires an agreement between two or more persons, with a specific intent to agree and to commit the offense, and an overt act in furtherance of the conspiracy. Circumstantial evidence (conduct, relationship, activities) supported the existence of a conspiracy.

Money Laundering

The elements of the crime of Money Laundering requires conducting transactions over $5,000 through financial institutions with intent to promote criminal activity or knowing the funds are proceeds of crime. The record evidence showed Bonavilla conducted financial transactions with knowledge they were proceeds of insurance fraud.

CONCLUSION

The appellate court affirmed Bonavilla’s convictions for conspiracy to commit insurance fraud, insurance fraud, solicitation to commit insurance fraud, and money laundering. The court found substantial evidence supporting each conviction and rejected Bonavilla’s arguments regarding sufficiency of the evidence including that defendant aided and abetted Dr. Iqbal in presenting fraudulent claims for health benefits to three insurance companies-Health Net, United Healthcare, and Aetna-with the specific intent to defraud the insurers.

Defendant and Dr. Iqbal targeted unsophisticated patients, some of whom had difficulty reading English. Patients were given a packet of documents and urged to complete the forms quickly and to sign where indicated. The patients testified they trusted Dr. Iqbal and signed the forms without reading them or asking what they were agreeing to. Defendant then submitted the applications, on behalf of Free Choice, and obtained group health insurance policies for those patients based on false representations the patients were eligible employees. The goal of the scheme to enroll patients in group insurance plans was for Dr. Iqbal to bill for more services and earn more for himself and defendant. Dr. Iqbal agreed to pay defendant and Free Choice 30 to 35 percent of the fees he eventually collected from the insurers for those services.

ZALMA OPINION

Insurance fraud, especially health insurance fraud, is a rampant means of keeping health insurance from people who are truly in need only to enrich criminals and physicians who have forgotten the oaths they took when they became physicians. Working with Bonvilla Dr. Iqbal and others deceived and hurt the patients rather than provide actual needed medical attention. The California Court of Appeals decided properly to affirm the convictions.

(c) 2025 Barry Zalma & ClaimSchool, Inc.

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