People v. Scofield

17 Cal. App. 3d 1018, 95 Cal. Rptr. 405, 1971 Cal. App. LEXIS 1549
CourtCalifornia Court of Appeal
DecidedMay 28, 1971
DocketCrim. 16494
StatusPublished
Cited by33 cases

This text of 17 Cal. App. 3d 1018 (People v. Scofield) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
People v. Scofield, 17 Cal. App. 3d 1018, 95 Cal. Rptr. 405, 1971 Cal. App. LEXIS 1549 (Cal. Ct. App. 1971).

Opinion

*1022 Opinion

REPPY, J.

By grand jury indictment defendant-appellant H. Edward Scofield, along with Dr. Everett W. DeLong (Dr. DeLong) and Freda Mae Nelson (Nelson), was charged with presenting a fraudulent insurance claim to the Aetna Casualty and Surety Company (Aetna) on or about June 1, 1962, in violation of Insurance Code section 556, subdivision (a). 1 After a jury waiver (a subject of contention on appeal) the matter was submitted on the transcripts of the preliminary hearing and of the grand jury indictment proceedings. 2 Defendant was found guilty of attempt of violation of section 556, subdivision (a) of the Insurance Code, a lesser and necessarily included offense and sentenced to 90 days in the county jail.

The trial court stated that it had examined grand jury exhibit No. 20 and had read the testimony of Harold E. Crozier, Jr., (Crozier), Dean C. Dunleavy (Dunleavy), Claris Von Berg (Von Berg), Ann Moran (Moran), and Mary DuBois (DuBois). Exhibit 20 consists of several bills for treatment rendered to Nelson. Two are from Doctors Hall and Matzen for radiology. One (hereinafter referred to as the May 18 bill) is addressed to defendant and consists of six pages. The first three pages, signed by Dr. DeLong and dated May 15, 1962, are Nelson’s medical history, diagnosis, and prognosis. The remaining three pages, dated May 18, 1962, are itemized statements setting forth the individual dates of treatments, commencing March 21, 1960, and ending May 8, 1962, the type of treatments, and the charges for the treatments, totalling $1,759.

The following is a summary of the testimony of each of the witnesses referred to by the trial court: 3

Crozier: As claims representative for Aetna, he investigated a claim filed personally by Nelson arising out of a March 16, 1960, auto accident. A suit for damages on the claim and for lulling Nelson into a false sense of *1023 security in letting the statute of limitations run was brought against Aetna and Crazier, with defendant acting as Nelson’s attorney. Crazier received from Aetna’s attorney, Dunleavy, letters written by defendant representing that he on behalf of Nelson, was making a claim of $6,000 and the medical bills (in Exhibit 20) which had been submitted in support of this claim. Dunleavy’s letter transmitting the bills was dated June 15, 1962, and indicated that he had received them a “few days [previously] from plaintiff’s counsel.”

Dunleavy: He negotiated Nelson’s claim against Aetna with defendant, her attorney. On June 1, 1962, defendant sent him the May 18 bill in support of that claim. On August 20, 1962, Dunleavy took Nelson’s deposition, with defendant present at defendant’s elaborate home in Beverly Hills. He had a lengthy discussion with defendant on Nelson’s treatments, almost entirely physiotherapy, which defendant told him had been given by Dr. DeLong.

Von Berg: She was employed by Dr. DeLong as a medical assistant and office worker who handled the office overload of medical insurance from June until the second week in November 1961. Defendant came to the office many times, once or twice as a patient, and otherwise on personal business calls. Dr. DeLong instructed her that defendant’s clients were to be billed for treatments three times a week regardless of whether actual treatment had been given. She was to check with defendant concerning the duration of the treatments to be put on the billing and how much the final settlement should be. She would call defendant’s office and receive his instructions although she did not talk to him personally. She gave Nelson injections, at the most, twice a week. Although it was her duty to render physiotherapy treatments and she would have known about any such treatments, she did not render any to Nelson. During her period of employment, Nelson did not visit the office as often as, or receive the physiotherapy treatments, reflected in the bill. She overheard conversations of defendant and Dr. DeLong regarding certain patients, what the insurance settlements should be, when the cases should be terminated, and when they should be submitted. Defendant would receive copies of bills for his clients.

Moran: She was employed by Dr. DeLong from June 1961 to January 2, 1962, as a technician and general office worker. She gave physiotherapy only once or twice. She was instructed by Dr. DeLong and defendant that she should bill defendant’s clients as if they had received treatment three times a week (some treatments, taken from the patient’s chart, were authentic; others were filled in by the use of the calendar), and that she should call defendant to find out the amount of the bill. After making the bill, *1024 she would fill in the “phony” treatments on the patient’s records. She took some of the bills to defendant’s home personally. She gave Nelson perhaps one shot and no physiotherapy treatments. During her employment, Nelson did not come to the office for treatment as frequently as the May 18 bill indicated. Nelson came to the office in reference to insurance and called often wanting to know why the insurance papers were not sent through. Moran prepared one bill for Nelson, but not the May 18 bill. Moran left the office when narcotics agents and the FBI started investigating and questioning the personnel.

DuBois: She worked for Dr. DeLong, replacing Von Berg, from October 1961 through November 1962, as a medical assistant and as compiler of insurance forms and personal injury reports. The cases of defendant’s personal injury clients were not put in the regular bookkeeping system; these patients had separate cards. She prepared bills for defendant’s clients showing treatments, which were not in fact true reflections of what patient records showed, according to telephoned instructions from defendant. Dr. DeLong told her that it was the office’s policy to submit fraudulent bills to insurance companies, that it would submit a bill for at least $300 for $100 worth of treatment, and that defendant, the patient, and “we” would each get $100. Defendant instructed her to lower the charges made for his clients because insurance companies balked at their size. DuBois treated Nelson occasionally. She prepared the May 18 bill, which reflected physiotherapy treatments and injections which had not been given. Some of the information on that bill was taken from Nelson’s patient records and some “from the calendar three times a week.” Defendant did not specify any particular amount for this, “but the instructions were to make the bill to begin treatments at the time of the accident, up until the last treatment date.” On January 12, 1962, while visiting defendant in his home with Levine, DuBois was told by defendant “that if anybody tried to do to him what evidently was trying to be done to Dr. DeLong, he would be like a rat in the corner, and he would have his back in the corner like a rat, and he would kill the person, whoever it was.” At that time defendant pointed his finger at DuBois and said that she was the only one who could implicate him relative to the insurance frauds.

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Cite This Page — Counsel Stack

Bluebook (online)
17 Cal. App. 3d 1018, 95 Cal. Rptr. 405, 1971 Cal. App. LEXIS 1549, Counsel Stack Legal Research, https://law.counselstack.com/opinion/people-v-scofield-calctapp-1971.