skip to Main Content
Name: People v. Riddles
Case #: D069419
Court: CA Court of Appeal
District 4 DCA
Division: 1
Opinion Date: 03/23/2017
Summary

Trial court did not abuse its discretion in awarding restitution for insurance company’s lost premiums resulting from defendant’s workers’ compensation fraud. Defendant Riddles pleaded guilty to workers’ compensation fraud in violation of Insurance Code section 11760, subdivision (a), based on allegations that, in his application for workers’ compensation insurance, he represented that a number of nurses who had been placed in residential care facilities were actually computer programmers. This misrepresentation reduced his premiums because the rate for workers’ compensation for computer programmers is less than the rate for nurses. The trial court required Riddles to pay $37,000 in restitution to the insurer—the value of the premiums the insurer would have earned in the absence of Riddles’ misrepresentation. Riddles appealed, arguing the trial court abused its discretion in ordering him to pay the amount of the premium loss suffered by the insurance company. Held: Affirmed. The restitution statute allows for recovery of a broad variety of economic losses that are incurred as a result of a defendant’s criminal conduct, including but not limited to “wages or profits lost by the victim.” (Pen. Code, § 1202.4, subd. (f)(3).) The “including, but not limited to” language in the statute permits a trial court to award restitution for any economic loss proved to be the direct result of a defendant’s criminal conduct, even if it is not specifically enumerated in the statute. Here, the record showed that, had Riddles accurately represented the individuals working as nurses, the insurance company would have recovered substantially more in premiums. The only circumstance that might break this causal link is a finding that Riddles would not have obtained any coverage had he been required to pay for the nurses as nurses. Such a finding is not supported by the record in this case, which showed that Riddles’ business partner required that he obtain coverage. Because Riddles exposed the insurance company to the risk of having to pay workers’ compensation claims for nurses working at Riddles’ agency, the insurance company is entitled to be compensated for that risk.

The full opinion is available on the court’s website here: http://www.courts.ca.gov/opinions/documents/D069419.PDF