Arrests for April 2002
These arrests were made possible through the cooperation of the Frauds Bureau, law enforcement, the insurance industry and the public.
To report suspected incidents of insurance fraud, call 1-888-FRAUDNY
CAUGHT!
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- GUILTY
- A resident of Lindenhurst in Suffolk
County was sentenced on 4/12/02 to two-to-six years in prison
for his role in what is believed to be the largest auto insurance
fraud investigation in New York State history. He recruited friends
and neighbors to file false accident reports and "juiced"
claims by intentionally damaging cars and motorcycles to fatten
claim checks. He pled guilty to enterprise corruption, a Class
B felony charge used by Suffolk DA Thomas Spota against the leaders
of a criminal enterprise involving auto body shops in a number
of western Suffolk County locations. This is the first major conviction
for the Suffolk County District Attorney’s Insurance Crime
Unit. The Unit includes investigators from the Department’s
Frauds Bureau, prosecutors, detectives and agents from the National
Insurance Crime Bureau.
On 4/3/02, a jury found another defendant in this continuing investigation guilty of insurance fraud, grand larceny and conspiracy. The defendant, a prior felony offender, conspired with a motorcycle owner and the operator of a body shop to defraud Windsor Insurance Company of nearly $4,600. He agreed to file a fraudulent accident claim with Windsor stating that his car had struck the motorcycle. Because the defendant’s auto policy had expired on July 19, 2000, the three agreed to state that the "accident" had occurred on July 16. The motorcycle owner agreed to bring it to the body shop of the third conspirator, where it was intentionally damaged. Thus far, more than 250 people have been arrested for fraud, grand larceny, forgery and other charges in the investigation.
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Two medical doctors pled guilty to felony insurance fraud charges, admitting to fraudulently embellishing and falsifying their reports on the examinations of undercover investigators who posed as accident victims. The two doctors are the first medical doctors convicted of insurance fraud in New York State. They were sentenced to three years of conditional discharge. The medical facility at which they were employed was sentenced to pay a fine of $2,500. The doctors also face disciplinary hearings before the New York State Health Department’s Office of Professional Medical Conduct which could result in fines and/or license suspensions or revocations. They were among 112 individuals and four corporations charged on 12/5/01 for involvement in one of the largest no-fault auto insurance rings ever uncovered in New York. Eleven of the 19 individuals indicted in the scheme have pled guilty to various charges ranging from enterprise corruption to insurance fraud, all felonies, and five individuals are currently serving state jail sentences. One of those individuals, an NYPD Administrative Aide, pled guilty in January 2002 to enterprise corruption and admitted that she had created fake accident reports as part of the scheme. An additional 68 individuals charged in separate criminal complaints have pled guilty in the case. The investigation was conducted by the Frauds Bureau; the Queens District Attorney’s Office; the NYPD; and the State Police.
- A crew manager at an upstate fast-food restaurant pled guilty on 4/1/02 to grand larceny in the 4th degree, perjury in the 3rd degree and insurance fraud in the 5th degree for collecting $5,168 in workers’ compensation benefits under false pretences. From 9/29/00 to 5/17/01, she submitted false work-status reports to First Cardinal Insurance Company and lied under oath at her workers’ compensation hearing. She was sentenced to 50 hours of community service and ordered to repay the money she collected fraudulently from First Cardinal. The investigation that led to her arrest was conducted by the Frauds Bureau with the assistance of the Workers’ Compensation Inspector General’s Office.
- An upstate woman was arrested and pled guilty on 4/10/02 to charges that between 9/29/00 and 4/27/01, she collected approximately $8,000 in workers’ compensation benefits from The Hartford Insurance Company while employed full time at an employment agency. At a workers’ compensation hearing on 4/2/02, the defendant denied being employed; however, The Hartford produced a video of her at her work place. She agreed to pay full restitution to The Hartford and will be sentenced in June 2002. The Buffalo Police Department executed the arrest based on information uncovered during an investigation by the Frauds Bureau.
- A Bronx man was found guilty of fraud in federal court for his involvement in a $500,000 life insurance scheme that targeted Prudential Life Insurance Company. The man, who is also a minister at a New York City Church, obtained a false Social Security number and a New York nondriver identification card in 1996 in the name of a fictitious brother. Then posing as the brother, he purchased a life insurance policy and three years later filed a claim. Prudential became suspicious of the claim and reported it to the Frauds Bureau. A joint investigation led to his arrest.
- A resident of Lindenhurst in Suffolk
County was sentenced on 4/12/02 to two-to-six years in prison
for his role in what is believed to be the largest auto insurance
fraud investigation in New York State history. He recruited friends
and neighbors to file false accident reports and "juiced"
claims by intentionally damaging cars and motorcycles to fatten
claim checks. He pled guilty to enterprise corruption, a Class
B felony charge used by Suffolk DA Thomas Spota against the leaders
of a criminal enterprise involving auto body shops in a number
of western Suffolk County locations. This is the first major conviction
for the Suffolk County District Attorney’s Insurance Crime
Unit. The Unit includes investigators from the Department’s
Frauds Bureau, prosecutors, detectives and agents from the National
Insurance Crime Bureau.
- WORLD TRADE CENTER FRAUD
- On 4/3/02, a Brooklyn man was arrested and charged with falsely claiming his 1999 BMW was destroyed in the garage of the WTC on 9/11. GEICO Insurance Company reimbursed him $38,361 for the loss. However, an investigation conducted by the Frauds Bureau; the NYPD’s Fraudulent Accident Investigation Squad; the Brooklyn District Attorney’s Office; the NICB; and GEICO’s Special Investigations Unit revealed that the suspect subsequently attempted to insure the same BMW with the same insurer--GEICO. The BMW was recovered at the time of the arrest.
- On 3/20/02, a woman was arrested in Tampa, Florida and returned to New York to face charges that she submitted a fraudulent claim to MetLife Insurance Company for $500,000 in death benefits on behalf of the beneficiary, her 14-year-old daughter. This defendant claimed that her ex-husband, whose life was insured by the policy, resided in New York City and died while at his job as an engineering maintenance worker at the World Trade Center on September 11. MetLife found the claim suspect and reported their suspicions to the Frauds Bureau. The investigation conducted jointly by the Frauds Bureau and MetLife revealed that the insured was alive and living in Miami, Florida. He was unaware that his ex-wife was attempting to collect the benefits of his insurance policy.
- AGENT FRAUD
Arrested on 4/26/02
Charged with forgery in the 2nd degree, offering a false instrument for filing in the 1st degree, petit larceny and scheme to defraud in the 3rd degree
A licensed insurance agent was accused of taking insurance premiums from nine clients but failing to remit them to the appropriate insurer. He was also charged with issuing six fraudulent auto insurance identification cards and providing documents to a business owner indicating that the business had proper insurance coverage when in fact no coverage existed. His arrest came as a result of an investigation conducted jointly by the Frauds Bureau and the Monroe County Sheriff’s Office.
- ONE CLAIM ONLY
Arrested on 4/24/02
Charged with grand larceny in the 3rd degree
Following a report of suspected fraud by New York Central Mutual Fire Insurance Company’s Special Investigations Unit, the Frauds Bureau and the City of Albany Police Department conducted an investigation that led to the arrest of the defendant in this case. The suspect, a health care worker, received almost $5,000 for repairs to her car after she was involved in an accident. However, she allegedly filed a claim with the other driver’s insurer and received a second payment for the same repairs. When she was confronted with the evidence, she refused to relinquish the second check.
- LICENSE REVOKED
Arrested on 4/23/02
Charged with forgery, criminal possession of a forged instrument, criminal possession of a forgery device, insurance fraud in the 5th degree and petit larceny
A former licensee whose license was revoked in 1999, was accused of selling bogus auto insurance policies to a number of individuals, several of whom were senior citizens in the Hispanic community. In addition, some of his customers learned that their policies were not valid only after they were involved in an auto accident. The Frauds Bureau joined the NYPD’s Fraudulent Accident Investigation Squad in the investigation.
- THIS AIN’T RENSSELAER
Arrested on 4/24/02
Charged with insurance fraud in the 3rd degree
An investigation by the Frauds Bureau; the City of Albany Police Department; and New York Central Mutual Fire Insurance Company’s Special Investigations Unit led to the arrest of the suspect in this case. She was charged with reporting that her car had been stolen in the City of Rensselaer on 12/29/01. However, evidence uncovered during the course of the investigation revealed that her car was found burned and abandoned in New York City on 12/28/01.
- GENERATING FRAUD
Arrested on 4/17/02
Charged with insurance fraud in the 3rd degree
A self-employed homebuilder was charged with submitting a claim for nearly $4,000 for the theft of items from his garage. However, an investigation by the Frauds Bureau and Travelers Insurance Company uncovered evidence that he increased the cost of a stolen generator by $500 on the receipt submitted to Travelers as proof of purchase.
- OVERPRICED
Arrested on 4/17/02
Charged with insurance fraud in the 4th degree
An inventory clerk from Buffalo reported to his insurer that his home had been burglarized and a bracelet and watch worth $1,300 stolen. However, following an investigation by the Frauds Bureau and the New York State Police, he was arrested and charged with submitting falsified receipts to verify the purchases. Evidence revealed that the cost of these items was actually $289.
- BAD ACTOR
Arrested on 4/13/02
Charged with insurance fraud in the 4th degree and falsifying business records in the 1st degree
An unemployed Elmira man was accused of collecting no-fault benefits to which he was not entitled. The charges against him allege that he submitted a written statement to Progressive Insurance Company that concealed information concerning a change in the nature of his no-fault disability claim. Evidence turned up in an investigation by the Frauds Bureau; the Elmira Police Department; and Progressive’s Special Investigations Unit indicated that no disability existed. At a later date, during an Independent Medical Exam requested by Progressive, he allegedly behaved in a way that led the doctor to report that he suffered from a rather severe disability. However, further evidence showed no physical disability.
- ELECTRONIC SHENANIGANS
Arrested on 4/11/02
Charged with insurance fraud
As a result of a joint investigation by the Frauds Bureau and the New Jersey Attorney General’s Office, three Brooklyn residents were arrested and charged with defrauding Prudential Insurance Company of a total of $17,300. The charges allege that, in separate transactions, these defendants sought auto insurance by telephone, stating they would submit premium payments electronically to secure coverage. However, although no money was transferred, they were able to receive refunds when they later "cancelled" the coverage. This investigation is continuing with emphasis on an internal probe at Prudential.
- NO TREATMENT NECESSARY
Arrested 4/10/02
Charged with falsifying business records
A report of suspected insurance fraud by New York Central Mutual Fire Insurance Company sparked an investigation by the Frauds Bureau and the State Police that led to the arrest of an unemployed food service worker. The suspect was charged with submitting fraudulent documents seeking reimbursement for expenses she purportedly incurred for medical treatment, physical therapy and hospital visits for an injury allegedly sustained in an auto accident. However, the investigation uncovered evidence that she was not at any of the facilities nor did she receive treatments on any of the dates and times indicated on the claims she submitted.
- LIGHTNING STRIKES TWICE
Arrested on 4/8/02
Charged with insurance fraud in the 3rd degree and grand larceny in the 3rd degree
The suspect in this case was accused of filing a fraudulent claim with State Farm Insurance Company for damage to a custom-built computer system that resulted from a lightning strike at his home on 4/11/01. He submitted allegedly fraudulent documents to support the purchase, ownership and possession of the computer system and was subsequently paid $1,128 for his loss. Several months later, on 8/15/01, he submitted a second claim to State Farm for damage to another computer system as a result of a second bolt of lightning striking his home. The defendant maintained that while he was transporting the second computer system for an independent analysis of the damage, as instructed by State Farm, the system was stolen from his car. He again submitted allegedly fraudulent documents of ownership. An investigation by the Frauds Bureau and State Farm’s Special Investigations Unit led to his arrest.
PRIOR SUPPLEMENTS
March 2002
- SENTENCED
On 3/11/02, an Ellicottville, NY, man was sentenced to five years’ probation and ordered to pay a fine of $1,000 after pleading guilty a month earlier to insurance fraud in the 4th degree. An investigation by the Frauds Bureau led to his arrest in January 2000 on charges of insurance fraud, arson and attempted grand larceny after a fire at his home. He subsequently filed a fraudulent claim with Liberty Mutual Insurance Company totaling $59,130 for the loss.
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NO COVERAGE
Arrested on 3/28/02
Charged with criminal possession of a forged instrument in the 2nd degree, insurance fraud in the 4th degree and workers’ compensation fraud
As a result of an investigation by the Frauds Bureau and the State Insurance Fund, a Latham man was accused of possessing two forged certificates of insurance and submitting them to his employer as proof of coverage where no coverage existed.
SEPTEMBER 2001
- HIS HOUSE WAS NOT HIS HOME
In September 2001, an upstate resident pled guilty to insurance fraud in the 4th degree and was sentenced to reimburse Nationwide Insurance Company for $1,500 in investigation costs and placed on five years’ probation. This fraudster was the occupant of a house in Buffalo in April 2000 when an accidental fire caused $21,000 in damages. He was a prior owner of the house and filed a claim under a policy that he had obtained while he was the homeowner. However, an investigation by the Frauds Bureau and Nationwide revealed that he had sold the house in November 1999, well before the fire occurred. The true owner of the house was unaware of the attempt to collect benefits for the loss at his property.
